President Donald Trump has nominated Susan Monarez, an infectious disease researcher and current acting director of the Centers for Disease Control and Prevention (CDC), to become the agency’s permanent leader. With top CDC officials departing and skeptical staffers watching closely to see whether she will follow science over politics, Monarez faces a stiff challenge.
“Dr. Monarez understands the importance of protecting our children, our communities, and our future,” Trump //truthsocial.com/@realDonaldTrump/posts/114219231809224627" style="box-sizing: border-box; color: rgb(202, 32, 21); text-decoration: underline; background-color: transparent; word-break: break-word;">wrote Monday afternoon in a post on the social media service Truth Social, further claiming that “Americans have lost confidence in the CDC due to political bias and disastrous mismanagement.” He added that Monarez would work closely with Robert F. Kennedy Jr., who was confirmed last month as secretary of the Department of Health and Human Services (HHS).
Trump had originally picked physician David Weldon for the role. But earlier this month, that nomination ended in an abrupt, chaotic withdrawal—mere hours before the former congressman, whose skeptical views on vaccines alarmed many in the medical community, was set to appear at a Senate confirmation hearing.
Monarez’s nomination may come as a surprise to Republicans and others. A week after his nomination was pulled, Weldon told CBS News that Florida Surgeon General Joseph Ladapo should be “at the top of President Trump’s list” to lead CDC. Sources initially told Reuters, meanwhile, that the White House was considering obstetrician-gynecologist and former Texas Representative Michael Burgess, another Republican, for the position.
Monarez, who holds a Ph.D. in microbiology, was appointed acting CDC director in January. A veteran government employee largely known for her roles in health technology and biosecurity, she had been serving as deputy director of the Advanced Research Projects Agency for Health (ARPA-H), where she led initiatives focused on using artificial intelligence to improve health outcomes. She has also held roles at the White House Office of Science and Technology Policy and the Department of Homeland Security.
Georges Benjamin, who serves as executive director of the American Public Health Association, was hoping for a CDC director with a respect for science and experience working in public health—and believes Monarez meets those criteria. “She checks off a lot of the boxes that I thought were important,” he says, adding that some of the other potential nominees would have been “horrific.”
Monarez will be the first CDC director to require Senate confirmation, following a law change in 2022 intended to enhance congressional oversight of the agency in the wake of the COVID-19 pandemic. If confirmed, she would also be the first nonphysician to lead the $9 billion public health agency since 1953.
Although many in the public health community are hopeful about the nomination, some CDC staffers have raised concerns, noting that Monarez has not been a particularly visible—or communicative—leader at the agency. As acting director, Monarez has issued just two agencywide communications to CDC’s staff—one email of introduction when she began working there and another welcoming staff back to the office, a CDC scientist tells Science. In the absence of top-level direction, staff members have struggled to interpret the Trump administration's executive orders and memos on topics such as a required pause in external communications and governmentwide spending, says the scientist, who spoke on condition of anonymity because they are not authorized to speak about CDC matters publicly
Several CDC officials also told The New York Times that Monarez has not attended the agency’s all-hands meetings. Other anonymous sources told the outlet that when the Trump administration ordered federal agencies to pull down websites that “inculcate or promote gender ideology,” Monarez did not resist or attempt to preserve important data.
Going forward, Monarez is likely to face scrutiny over several controversial moves made during her time as acting CDC director, including the postponement of a vaccine advisory committee meeting and the White House’s influence over the agency’s supposedly independent flagship medical research publication, the Morbidity and Mortality Weekly Report. Her confirmation hearing may include questions about plans to research the long-debunked link between vaccines and autism, and planned cuts to the CDC workforce. And just yesterday, STAT reported that five high-level CDC officials were joining a recent exodus.
“Effective leadership at CDC is critical to protecting health and saving lives, especially in times of crisis,” says Tom Frieden, who served as director of the agency from 2009 to 2017. “What’s most important is a strong, science-driven CDC that earns and maintains public trust."
If confirmed, Monarez will inherit several ongoing public health threats, including multistate outbreaks of measles and the bird flu. “She has her work cut out for her,” Benjamin says. “If she does this well, she will be able to help the organization through some very difficult times.”
More: https://www.science.org/content/article/trumps-new-cdc-pick-work-cut-out-for-her
