President
Susan Monarez is currently the CDC’s acting director after previously serving as deputy director for the Advanced Research Projects Agency for Health, an agency created by the Biden administration focusing on biomedical research.
Her work on biosecurity and artificial intelligence in various government roles, including with the Obama White House, stands in sharp contrast with other Trump administration health officials who lack government experience and a scientific background.
Trump recently withdrew the nomination of his first CDC pick, Dave Weldon—a former US representative for Florida, physician, and vaccine skeptic—after senators made clear there weren’t enough votes to secure confirmation. Trump’s is the first CDC director who will require Senate confirmation, after lawmakers made a change in 2022.
Weldon’s rejection was seen as a blow to Health and Human Services Secretary Robert F. Kennedy Jr., who has known him for years and shares concerns about the safety of vaccines despite overwhelming evidence.
“She’s an actual scientist. And someone who served in a senior role in the previous administration,” said Yaniv Heled, a Georgia State University law professor specializing in biomedical technologies.
By contrast, Weldon was “an incredibly divisive character who had expressed opinions that are not grounded in science,” Heled said.
But Kennedy and the Trump administration’s broader efforts to overhaul public health and the operations of the federal government mean Monarez is likely to be constrained even with her experience.
Combating Skepticism
Trump said on Truth Social that Monarez would “work closely” with Kennedy, and that the two would “prioritize Accountability, High Standards, and Disease Prevention to finally address the Chronic Disease Epidemic and, MAKE AMERICA HEALTHY AGAIN!”
Kennedy, posting on social media site X, said he “handpicked Susan for this job because she is a longtime champion of MAHA values, and a caring, compassionate and brilliant microbiologist and a tech wizard who will reorient CDC toward public health and gold-standard science.” MAHA refers to Kennedy’s Make America Healthy Again agenda, which focuses on chronic diseases.
Monarez appears a more balanced choice, “at least on paper,” said Ana Santos Rutschman, faculty director at Health Innovation Lab at Villanova Law, noting the CDC pick knows “the ins and outs of the agency she may come to lead,” unlike nominees such as Mehmet Oz, the celebrity doctor and TV host Trump picked to lead the Centers for Medicare & Medicaid Services.
However, Monarez’s nomination alone won’t “be sufficient to act as a countervailing force to the escalating vaccine skepticism” both within the regulatory state and broader public, according to Santos Rutschman.
The Trump administration postponed a meeting in February of the Advisory Committee on Immunization Practices, a panel that makes vaccine recommendations to the CDC. The meeting was later scheduled for April. Also in February, the administration canceled a Food and Drug Administration advisory meeting on the flu vaccine and US health officials began reconsidering a $590 million contract with
Earlier this month, the CDC published routine conflict of interest disclosures online in a way that health experts said fueled unnecessary skepticism of scientific integrity.
And a day after Monarez’s nomination, news outlets reported that five key CDC leaders were retiring from the agency.
Monarez is “under policymakers that have clearly established” that certain vaccines should be reviewed or reassessed, Santos Rutschman said.
“I very much doubt she will be able to single-handedly counter this trend—and doing so might also ultimately be unproductive for the CDC, because they have many non-vaccine-related goals to pursue, and perhaps that’s where Dr. Monarez will have more leeway” to prepare for or respond to public health threats or concerns, Santos Rutschman said.
Funding and Workforce
The Trump administration is reviewing plans to dramatically reduce the size of the federal government and its work force. Those changes will likely mean the overhaul and outright elimination of a number of offices important to public health.
The changes come amid concerns from public health watchers about the potential spread of harmful viruses such as bird flu and measles. The CDC said that as of March 20, over 370 cases of measles were reported across 18 jurisdictions.
“If she was allowed the independence to make science based decisions on public health issues like vaccines, and the CDC was properly funded and allowed to maintain and expand its workforce in order to respond to public health challenges, I would be more optimistic” about Monarez serving a “stabilizing role” for the administration, said Liza Vertinsky, professor of law at the University of Maryland Francis King Carey School of Law.
Vertinsky said it’s “unlikely” that Monarez “will be provided with the independence and authority to make decisions that are in tension with the approach that RFK has been taking.”
“There have been no visible signs of her pushing back against the executive orders or workforce reductions taking place while she has been acting CDC director,” Vertinsky said.
Monarez “is likely to preside over an agency in turmoil and badly wounded by mass departures of senior scientists and directions from the HHS secretary to engage in unscientific research,” said Lawrence Gostin, professor of global health law at Georgetown Law.
“The test of the new director is whether she will stand up for science and vaccines in the face of interference from the secretary and the White House,” Gostin said.
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