After enduring months of staffing cuts and disease outbreaks without a permanent leader, the Centers for Disease Control and Prevention (CDC) has finally appointed a new director. The Senate has confirmed Susan Monarez, a seasoned health scientist and dedicated civil servant, to lead the public health agency. Monarez's confirmation marks a historic moment, as she is the first CDC director to be approved by the Senate under a new law enacted in 2023, and notably, the first in over 70 years to hold the position without a medical degree.
The Senate vote, which concluded with a narrow margin of 51-47 along party lines, reflects the polarized environment in which Monarez assumes leadership. According to employees who have spoken to NPR, the CDC is currently experiencing a state of chaos, with thousands of employees leaving the agency and significant cuts to support for various programs. Adding to the agency's challenges, former President Trump has proposed drastic reductions to the CDC's funding for the fiscal year 2026.
Jennifer Nuzzo, the director of the Pandemic Center at the Brown University School of Public Health, emphasized the importance of Monarez's role, stating, "We really need her in this role." Nuzzo, who has known Monarez professionally for over a decade, praised her as a loyal and hardworking civil servant who leads with evidence and pragmatism. Monarez, trained as a microbiologist and immunologist, previously served as the acting director of the CDC from January to March this year before stepping down when nominated for the permanent position.
Prior to her nomination, Monarez was the deputy director for the Advanced Research Projects Agency for Health (ARPA-H), a government agency focused on funding innovative biomedical and health research. Her nomination followed the withdrawal of Florida physician Dave Weldon, who faced scrutiny over his controversial stance on vaccines, including previously debunked claims regarding vaccine safety.
Dr. Georges Benjamin, executive director of the American Public Health Association, expressed optimism about Monarez's appointment, stating, "She values science, is a solid researcher, and has a history of being a good manager." The public health community is looking forward to collaborating with her as she takes on this critical role.
During her confirmation hearing before the Senate Health, Education, Labor, and Pensions Committee, Monarez identified restoring trust in the CDC as one of her top priorities. "I will rebuild credibility by making CDC leadership more public-facing and accountable," she asserted. Monarez emphasized the need to ensure that all recommendations are based on publicly available, gold-standard science.
In addition to restoring trust, Monarez plans to focus on modernizing public health infrastructure and enhancing the CDC's response to disease outbreaks. "We know the next outbreak is not a matter of if, but when," she stated, outlining her commitment to implementing evidence-informed protocols to minimize confusion during health crises.
Monarez faces the challenge of balancing traditional public health values with the agenda of her boss, Secretary of Health and Human Services Robert F. Kennedy Jr., who has expressed skepticism regarding vaccine safety. During her confirmation hearing, she reaffirmed her commitment to maintaining routine vaccines as a priority for U.S. children, stating, "Vaccines absolutely save lives." Monarez also voiced her support for the fluoridation of community drinking water, despite potential changes in guidance from the CDC under Kennedy's direction.
As she prepares to lead the CDC, Monarez will need to navigate a complex landscape of scientific integrity and political influence. Observers have raised concerns about her ability to uphold the independence expected of the CDC, especially given Kennedy's recent changes to the agency's advisory boards. "My biggest anxiety for her is whether she will be able to lead with the independence and commitment to evidence-driven strategies that she is known for," said Nuzzo.
Monarez inherits an agency grappling with significant staffing reductions, funding challenges, and a shift in focus away from certain health issues. According to Representative Rosa DeLauro's office, the CDC has lost about a third of its workforce since January, with further changes expected as part of an ongoing reorganization. Critics argue that the move to exclude noninfectious diseases from the CDC's mission is shortsighted, emphasizing that public health encompasses a broad spectrum of factors beyond infectious diseases.
As Susan Monarez takes the helm of the CDC, her leadership will be pivotal in addressing the myriad challenges facing the agency and restoring its reputation as a global leader in public health.
