The Centers for illness Control and Prevention has finally had a new head after months of enduring staff reductions and illness outbreaks without a formal leader.
Susan Monarez, a senior civil servant and health scientist, was confirmed by the Senate to lead the public health department. Under a law passed in 2023, she became the first CDC director to be confirmed by the Senate and the first to hold the position for more than 70 years without a medical degree. It was a party-line vote, 51-47.
Employees have told NPR that Monarez takes over an institution in disarray. In recent months, thousands of employees have departed, and funding for numerous projects has been reduced. For fiscal year 2026, President Trump has suggested cutting CDC spending.
“We really need her in this role,” says Jennifer Nuzzo, who has known Monarez professionally for over ten years and is the director of the Pandemic Center at the Brown University School of Public Health. “She’s a loyal, hardworking civil servant who leads with evidence and pragmatism, and has been dedicated to improving the health of Americans for the entirety of her career.”
CDC’s acting director from January to March of this year was Monarez, a microbiologist and immunologist by training, who resigned as needed when Trump selected her for the director position. She was previously deputy director of the Advanced Research Projects Agency for Health, also known as ARPA-H, a federal organization that provides funding for innovative health and biological research.
Monarez nominated after Weldon was withdrawn
When senators expressed reservations about Trump’s views on vaccines, including previously refuted assertions about vaccine safety, and indicated that he lacked the numbers to pass, he withdrew his initial choice, Florida physician Dave Weldon, and she was nominated to be the head of the CDC.
The American Public Health Association’s executive director, Dr. Georges Benjamin, who had earlier called Weldon “not the right guy for the job,” was optimistic about Monarez. “She values science, is a solid researcher, and has a history of being a good manager,” says Benjamin. “We’re looking forward to working with her.”
Restoring confidence in the CDC was one of Monarez’s key concerns during a June confirmation hearing before the Senate Health, Education, Labor and Pensions committee. “I will rebuild credibility by making CDC leadership more public-facing and accountable [and] ensure all recommendations are backed by publicly available, gold-standard science,” she stated.
Other priorities mentioned by Monarez were updating public health facilities and reacting quickly to disease outbreaks. “We know the next outbreak is not a matter of if, but when,” she stated. “I will implement tested, evidence-informed predefined protocols to avoid confusion and delays, and strengthen risk communication so the public receives timely, consistent guidance based on facts, not fear,” she continued. “These priorities support the President’s and the Secretary’s vision of a healthier America.”
Tension between public health norms and administration’s agenda
Monarez had to balance the views of her boss, Secretary of Health and Human Services Robert F. Kennedy Jr., who has long questioned the safety of vaccines, with those of traditional public health throughout the hearing. He is currently in charge of the National Institutes of Health, the Food and Drug Administration, and the CDC, among other federal health organizations.
When asked if she would pledge to maintain routine vaccines free for children in the United States by Delaware Democrat Sen. Lisa Blunt Rochester, Monarez responded, “Vaccines absolutely save lives, and if I’m confirmed as CDC director, I will commit to making sure that we continue to prioritize vaccine availability.”
Additionally, Monarez stated that she thinks fluoride plays a significant role in dental health and that the fluoridated tap water in her neighborhood is safe. Although Health Secretary Kennedy has instructed the CDC to modify its guidelines about the practice, citing health risks not identified at the authorized fluoride levels, low quantities of fluoride have been added to many community drinking water systems for decades in an effort to prevent cavities.
Throughout the session, Monarez supported the Trump administration’s plan for the CDC, saying it is “getting back to its core mission of preventing, detecting and responding to infectious diseases and emerging threats.” Programs that address other health conditions that she referred to as “important public health concerns,” such obesity, depression, drug addiction, chronic diseases, and overdose, would be moved to other HHS divisions, she added. Kennedy has declared his intention to establish a new Administration for a Healthy America, which might concentrate on environmental health, mental health, primary care, and other areas.
When asked about Kennedy’s performance as health secretary, Monarez responded, “I think he has prioritized key public health activities for preventing chronic diseases, for reducing maternal morbidity and mortality.” “The Secretary has laid out a very clear vision for making America healthy again,” Monarez said. In my opinion, the Secretary is carrying out the crucial task of guiding a highly intricate organization through several changes.
A scientific balancing act
According to experts, Monarez will have to strike a balance between her new boss’s skepticism of the scientific and medical establishment and fundamental scientific values. Kennedy, for example, has substituted his own selections, many of whom lack vaccine knowledge, for the CDC’s bench of vaccine experts. “My biggest anxiety for her is whether she will be able to lead with the independence and the commitment to letting the evidence drive the strategy approach that she’s known for,” Nuzzo, a professor at Brown University, says.
Monarez takes over an organization that is struggling with severe personnel reductions, funding retractions, and a communications crackdown. “Morale is very low,” Benjamin from the American Public Health Association, “CDC has always been the gold standard of public health organizations in the world, and it’s been paralyzed.”
According to statistics released by Representative Rosa DeLauro’s (D-CT) office, the CDC has lost around one-third of its employees since January.
An continuing reorganization attempt to remove noninfectious diseases from the CDC’s responsibilities is expected to result in more changes, including funding reduction.
Dr. Nirav Shah, a former principal deputy director of the CDC who departed the organization in February, says that’s shortsighted.
Shah asserts that “health is multifaceted,” citing factors such as exercise, diet, and living conditions in addition to the viruses and insects we are exposed to. As the CDC does now, a good public health organization should consider and weigh all of those hazards.
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