After CDC director’s firing, health leaders fear for the agency’s future

The turmoil atop the Centers for Disease Control and Prevention has alarmed healthcare leaders and triggered calls for a congressional investigation.

The White House fired CDC Director Susan Monarez Wednesday, less than a month after she took the post. Attorneys for Monarez said she refused to endorse “unscientific” directives or fire qualified CDC officials. Three other top CDC officials stepped down in protest.

Critics blasted Health & Human Services Secretary Robert F. Kennedy Jr., adding to concerns over changes in vaccine policy and his reorganization of the health department, which includes the CDC. Members of Congress say they want answers and pledged to look into the ouster of the CDC director.

Wendy Armstrong, MD, vice president of the Infectious Disease Society of America, said the firing of Monarez and resignations of three other top CDC officials weakened the country’s public health capabilities.

In a webinar with other health leaders Thursday, Armstrong said, “America is actually far less safe than we were at the beginning of yesterday.”

Georges Benjamin, MD, executive director of the American Public Health Association, pulled no punches. He described an effort “to really destroy the agency over the last several months.”

“The American people deserve a high functioning agency guided by science, and not having such an agency is costly,” Benjamin said. “It wastes taxpayer dollars, it impacts our health in a negative way, and it costs lives, and the CDC is the nation's most important prevention agency, and we've had enough.”

Benjamin said he hopes President Trump will intervene and reverse Kennedy’s "irresponsible" decision. He said Kennedy has failed as the health secretary.

Armstrong said the turbulence at the CDC needs to be addressed.

“In any organization or company, if the senior leadership team walked out en masse, we would have to recognize and accept that there is an irrefutable problem at the top,” she said. “In this case, Secretary Kennedy and his continuous attacks on public health.”

• Read more: Vaccine hesitancy: Doctors and health systems face more skepticism

Demanding investigation

Lawmakers fumed over the ouster of Monarez.

Sen. Bernie Sanders, I-Vermont, called for a bipartisan congressional investigation into the CDC director’s dismissal. Sanders is the top Democrat on the Senate Health, Education, Labor, and Pensions (HELP) Committee.

“The American people should hear directly from Secretary Kennedy and Dr. Monarez and every member of our committee should be able to ask questions and get honest answers from them,” Sanders said in a news release.

He also said he was troubled by the shake-up in CDC leadership.

“We need leaders at the CDC and HHS who are committed to improving public health and have the courage to stand up for science, not officials who have a history of spreading bogus conspiracy theories and disinformation,” Sanders said.

Sen. Bill Cassidy, R-Louisiana, serves as the chairman of the Senate Health Committee. A physician, Cassidy cast a critical vote that helped assure Kennedy’s confirmation as health secretary. He posted a short message on X on the CDC.

“These high profile departures will require oversight by the HELP Committee,” Cassidy wrote.

Cassidy also called for a key vaccine advisory panel to postpone a meeting in September, in part due to the CDC shakeup. Kennedy fired all 17 members of the Advisory Committee on Immunization Practices in June, to the chagrin of medical groups. Critics said Kennedy picked less qualified replacements. Cassidy said the meeting should be delayed because "serious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed."

"If the meeting proceeds, any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership,” Cassidy said in a statement Thursday.

Sen. Patty Murray, a Democrat from Washington State, acknowledged she had doubts about Monarez’s willingness to stand up to Kennedy, and she said Thursday, “I’m glad to say that I was wrong.”

Pointing to Kennedy’s long record of vaccine skepticism, Murray worried that other top posts at CDC will only be filled by those who subscribe to the health secretary’s views. She urged the White House to remove Kennedy as health secretary.

“We cannot let RFK Jr. burn what’s left of the CDC and our other critical health agencies to the ground—he must be fired,” Murray said in a statement. “I hope my Republican colleagues who have come to regret their vote to confirm RFK Jr. will join me in calling for his immediate termination from office.”

Questioned about the CDC director’s firing, White House Press Secretary Karoline Leavitt cited the statement from Monarez’s attorneys as proof that she was “not aligned with the president’s mission to make America healthy again.”

“We're going to make sure that folks that are in positions of leadership there are aligned with that mission,” Leavitt said.

Kennedy shared a clip from the White House news conference, and posted on X, “That’s how we will restore trust.”

Trump nominated Monarez in March, and she had served as acting CDC director since January. She was tapped after the White House withdrew the nomination of Dave Weldon, MD, a physician and former congressman.

• Read more: Doctors are facing an invasion of misinformation

‘Do not reflect scientific reality’

Dr. Demetre C. Daskalakis, director of the National Center for Immunization and Respiratory Diseases, is one of the CDC officials who walked away from the agency. He posted his resignation letter on X and pointed to changes ushered in by Kennedy making policy changes and not consulting CDC experts.

“I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health,” Daskalakis wrote. “The recent change in the adult and children’s immunization schedule threaten the lives of the youngest Americans and pregnant people.”

The resignation reflects the themes delineated by Monarez’s attorneys, Mark Zaid and Abbe David Lowell, in their statement Wednesday night after her dismissal was announced.

“When CDC Director Susan Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving a political agenda,” the attorneys said on X. “For that, she has been targeted."

• Read more: Assessing the end of mRNA research: ‘We just shot ourselves in both feet and both hands’

‘Highly alarming’

Healthcare advocacy groups say they’re worried about the CDC’s future, along with the nation’s ability to track diseases and prevent outbreaks.

Bobby M. Mukkamala, MD, president of the American Medical Association, called the ouster of Monarez and resignation of other CDC leaders “highly alarming.”

“This destabilization comes at a time when CDC’s credibility and leadership are more essential than ever,” Mukkamala said in a statement. “In the wake of CDC budget cuts and the termination of hundreds of employees earlier this year, the AMA is deeply concerned that this turmoil leaves us highly susceptible to public health threats.”

Medical groups also expressed concerns over the federal government’s approval of COVID-19 vaccines, with new restrictions that critics say will make it harder for millions to get the shots if they want them.

With flu season approaching, Armstrong said the CDC’s capabilities had already diminished even before Monarez’s firing and the other resignations.

“If this is our football team, we've lost our quarterback and we've lost the entire line,” Armstrong said. “You could debate whether that's the offensive line or the defensive line, but our team's still expected to play in the Super Bowl.”

Public health leaders say they’re worried about who would lead the CDC, or even be willing to take the job. They also said they’re gravely concerned that qualified candidates would have no interest in working for the agency after the events of recent months.

As Benjamin said, “Why would you take a job that is the one of the most important science-based jobs in the country, when you know that your boss doesn't support science or evidence?”