While the upheaval at the Department of Health and Human Services is getting more headlines, local public health organizations are also facing a moment of reckoning. Major cuts are leaving them with fewer resources and employees, which will have immediate ramifications. STAT editor Torie Bosch spoke with two directors of county-level public health departments: Raynard Washington of Mecklenburg County in North Carolina, and Michelle Taylor of Shelby County in Tennessee. The conversation was inspired by their recent First Opinion essay on the threat posed by the closure of the Centers for Disease Control and Prevention’s Office of HIV Prevention.