The sudden departures of five top officials at the Centers for Disease Control and Prevention (CDC) has rocked the public health community, with leading experts and organizations warning it may leave the United States unprepared for future outbreaks and pandemics.
In a single day, four key leaders of the CDC announced they would step down from their positions, following the ouster of CDC Director Susan Monarez, just weeks after her confirmation.
“These are uncharted waters,” said a senior CDC official during a Thursday all-hands meeting of the agency’s National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).
“But we will do our best to navigate, to move forward, to do the work that we think needs to be done in the way that it needs to be done.”
The departures leave the CDC “weakened, gutted and utterly dispirited,” said Lawrence Gostin, a professor of global health law at the O’Neill Institute at the Georgetown University Law Center and director of the WHO Center on Global Health Law.
“They have always been the nation’s premier scientific and public health agency, and they are kind of the gold standard for science and public health throughout the world,” he added.
“There is a reason why countries all around the world call themselves the CDC, and it’s because our science, our public health, had led the world and protected Americans for generations. All of that is ending.”
The White House on Thursday afternoon announced Health and Human Services (HHS) Deputy Secretary Jim O’Neill would replace Monarez on an interim basis. O’Neill was an HHS official in former President George W. Bush’s administration before working for ventures backed by tech billionaire Peter Thiel.
HHS Secretary Robert F. Kennedy Jr. went on Fox News on Thursday morning following Wednesday’s exodus, saying he was trying to “fix” the CDC and “it may be that some people should not be working there anymore.”
Calley Means, a top adviser to Kennedy, said the Trump administration was trying to restore faith in CDC that had eroded during the COVID-19 pandemic.
“The CDC’s job is to control disease. They receive an F on that mission. America is now the sickest country in the developed world, and had the highest rates of per capita COVID deaths because our health institutions have so woefully failed in keeping Americans healthy,” Means wrote.
“If CDC employees want to defend the status quo and aren’t aligned with a reform, they should resign,” he added.
Trump has yet to publicly comment on Monarez, whom he nominated to the role after his first pick to lead the CDC failed to garner enough support in the Senate.
A source close to Monarez said she had a “great rapport” with the president and had discussed her agenda for the CDC with him in detail prior to her nomination. But in the three weeks she served as CDC director, it became clear Kennedy’s agenda did not align with what Monarez laid out, they said.
Lawyers for Monarez and the four senior leaders who resigned pointed to the politicization of the agency under Kennedy as undermining their ability to make scientifically sound decisions. The HHS has also slashed the agency’s workforce in recent weeks.
Gostin worries the resignations and the extreme reduction in staff means the agency will not be able to do the work necessary to ensure Americans receive proper health advice and vaccination recommendations.
“When the next emergency hits, and it will, it will knock on the CDC’s door and there will be no one there because all the top scientists have left or are leaving,” he said.
Andrew Pekosz, a professor and vice chair of the department of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health, believes the resignations speak to how the CDC is moving toward processes that are either being driven by “misinformation or by non-scientific agendas.”
He said the flurry of resignations from the traditionally apolitical agency could mean there are fewer people within the agency willing to push back against controversial decisions made by the Trump administration regarding vaccines and other public health matters.
“We have some decisions that need to be made about vaccines this coming fall … influenza vaccines, COVID vaccines, other vaccines,” he said. “We are now going to see CDC director responsibilities fall to others.”
Senate Health Committee Chair Bill Cassidy (R-La.) echoed those concerns in a statement Thursday, calling for a delay in the planned meeting of the CDC’s vaccine advisory committee next month.
“Serious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed for the now announced September ACIP meeting,” Cassidy said in a statement, referring to the CDC’s Advisory Committee on Immunization Practices.
“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,” he added.
House Speaker Mike Johnson (R-La.) did not share his concern during an interview Friday on ABC’s “Good Morning America.”
“I think overall, Secretary Kennedy’s doing a great job,” he said. “There’s been a shake-up that’s been needed there, and I think we got to trust the secretary to do his job. They have had some great results there, we’re getting America healthy again, that’s well-received across the country and long overdue in my view, we’re going to let the Cabinet do their job, and I’m going to stay in my lane and do mine.”
Professional medical groups are coming forward in support of Monarez and CDC’s leadership amid the turmoil. These organizations are pleading for stability and continuity to be restored at the agency tasked with supporting U.S. public health.
Richard Besser, president and CEO of the Robert Wood Johnson Foundation and former acting director of the CDC, blasted the decision to dismiss Monarez in a briefing Thursday, calling it “chilling” and “deeply disturbing.”
“CDC career staff do not always agree with the HHS political appointees on matters of policy, but we have never had reason to question anyone’s commitment … to people’s health. But this administration is unlike anything we’ve ever seen,” said Besser.
Besser said he spoke with Monarez on Wednesday, during which she disclosed she did not expect to remain in the role much longer despite her refusal to accept the firing by HHS.
The Association for Professionals in Infection Control and Epidemiology (APIC) said the push to remove Monarez would leave the agency “leaderless at a time when [infection prevention and control] professionals rely on CDC guidance to manage emerging threats, antimicrobial resistance, and healthcare-associated infections”
Lisa Tomlinson, APIC vice president of government affairs, said this development dashed a degree of cautious optimism groups like hers had about the second Trump administration.
When Monarez was announced as Trump’s second choice to lead the CDC, Tomlinson said her organization’s reaction was, “This is a good sign. Maybe she’ll be someone that administration will be OK with, and we’ll be OK with too.”
