Susan Monarez, Trump’s CDC nominee, could be a good choice, if given the clout

Susan Monarez is President Donald Trump’s second pick to lead the Centers for Disease Control and Prevention, but she may not face the same backlash as his first choice.

Trump said Monday he is nominating Monarez to the post, which requires Senate confirmation. Monarez has been serving as the acting CDC director since January.

The president announced his choice of Monarez just days after the White House withdrew the nomination of Dave Weldon, MD, a physician and former congressman, when it was clear he lacked support. Weldon drew heavy scrutiny for some of his skepticism about vaccine safety, and critics also said he lacked experience with infectious diseases or running a health agency.

Monarez is not a medical doctor; she has a PhD in microbiology and immunology. She also brings experience in infectious diseases and working with government agencies.

She served as deputy director for the Advanced Research Projects Agency for Health, the federal agency created by former President Biden to develop cutting-edge studies that could lead to breakthroughs in cancer and other diseases. Monarez has also served in the White House in the Office of Science and Technology Policy and as a science adviser for the Department of Homeland Security.

Georges C. Benjamin, MD, executive director of the American Public Health Association, tells Chief Healthcare Executive® that Monarez is regarded as smart and experienced.

“She could be a very good CDC director,” Benjamin says. “Her confirmation hearings are coming, and we'll get to know a lot more about her through that.”

‘Her central challenge’

While saying she brings solid credentials to the job, Benjamin says she’s preferable to other alternatives who were mentioned as candidates. Benjamin didn’t mention the other names, but he said, “There were some alternatives that were either totally unqualified, training experience or competency, to do the job.”

Speaking generally about what he seeks in a CDC director, Benjamin says that he prefers to see a physician in the post, but he says he is encouraged that Monarez brings substantial experience with infectious disease work.

“She has undergraduate and graduate degrees in infectious diseases, and she's done a lot of emerging infectious disease work in her senior jobs,” he said, adding, “She made her bones on some of the infectious disease stuff early in her career.”

Benjamin says the CDC director should be “someone who has training and expertise in some of the important focal areas of public health and infectious diseases, and she's an expert there.”

The scope of Monarez’s influence to protect the CDC’s important work remains an open question, Benjamin acknowledges.

The CDC falls under the U.S. Department of Health & Human Services, which is now led by Robert F. Kennedy Jr. Like many other health leaders, Benjamin opposed placing Kennedy in charge of the health department due to his long record of misinformation on vaccine safety and lack of experience in running a healthcare organization. Scientists and healthcare leaders have criticized the CDC for launching a new study examining links between vaccines and autism.

Healthcare leaders have also spoken out against cuts in the CDC, from shedding positions to ending programs aimed at preventing the spread of HIV. The CDC indicated Tuesday it's pulling back billions of dollars in COVID funds sent to state health departments, a move that alarmed Benjamin.

Benjamin says he’s very concerned about the Trump administration’s moves to reduce the funding and scope of the agency.

The question is whether Monarez can convince the White House to preserve the CDC.

“I think that's her central challenge … letting people understand, here's what CDC ought to look like, here's what it needs, here's what it does, here's what it needs to do, here's why it's unique,” Benjamin says.

“No other agency in the federal government does prevention like CDC does, and so it does have a unique role and responsibility, and she is going to have to continue to advocate aggressively about that loudly,” he continues.

In his post on Truth Social announcing the nomination of Monarez to lead the CDC, Trump said she brings “decades of experience championing Innovation, Transparency, and strong Public Health Systems.” He added, “Dr. Monarez will work closely with our GREAT Secretary of Health and Human Services, Robert Kennedy Jr.”

‘Committed to science’

Tom Inglesby, MD, the director of the Johns Hopkins Center for Health, wrote on LinkedIn Tuesday that he has known Monarez for many years.

“She has always been committed to science, health, following the evidence where it leads, and doing the right thing …. She is good and fair to people, and wants to make people's lives better. She is the epitome of a senior public servant who doesn't do politics but gets things done,” Inglesby wrote.

Recognizing the current climate, Inglesby added, “If she is given the license to make scientific decisions about vaccine and other key public health issues, provided the budget to preserve and strengthen CDC's public health programs, allowed to retain the human capital, operations, and scientific workforce that CDC needs, I have no doubt Susan will be a very effective CDC leader during a challenging time.”

Benjamin says it’s uncertain about how much power Monarez will have.

“She's got her hands full for sure,” Benjamin says. “We are here in the civilian side of the world and the advocacy side are here to support the agency, and we'll be making strong arguments to not let those terrible cuts happen.”

Michael Mina, MD, an immunologist and epidemiologist who advises biotech firms, hailed Monarez as one of the best choices to lead the agency in years. In a series of posts on X, Mina wrote that Monarez has been focused on pandemics and infectious diseases.

“Dr. Monarez (PhD) has led a career focusing on population health and developing the technologies and tools required to drive public health forward,” Mina wrote. “This is a hugely needed departure from a long history of patient facing MD's tapped to run a population health institution.”

Sen. Bill Cassidy, a Louisiana Republican and a physician, looms as a key vote on Monarez’s confirmation. He issued a short statement after Trump announced his new nominee.

“CDC needs reform,” Cassidy wrote on X. “That’s why I launched a Senate Republican CDC working group. I look forward to meeting Dr. Susan Monarez and learning more about her vision for the agency.”

The CDC’s reputation has suffered, largely from decisions made outside the agency, Benjamin says.

“The CDC is still absolutely the gold standard,” he says. “All these talking points around here about CDC’s image are nonsense. The CDC is still the gold standard.”

If Monarez is confirmed, she could bring the credibility to get people to listen to her about the CDC’s needs and importance, or she could at least minimize the damage to the agency, Benjamin suggests.

“People can be inside the organization and keep them from doing the worst. Now, whether or not that will happen, I don't know, but she certainly has an opportunity to do that,” he says.

NIH, FDA leaders confirmed

The Senate confirmed two key health officials in the Trump administration Tuesday.

Senators voted 53-47 to confirm Dr. Jay Bhattacharya to lead the National Institutes of Health. Bhattacharya, MD, a professor of health policy at Stanford University, spoke out against the COVID-19 lockdowns. Medical schools and academic medical centers have protested the NIH's plans to cut billions in aid. The Senate vote fell along party lines.

The Senate also confirmed Marty Makary, MD, to lead the Food and Drug Administration. Makary is a surgeon and professor at Johns Hopkins University. The Senate confirmed Makary with a 56-44 vote, with three Democrats voting along with Republican senators.