After President Trump’s first nominee to lead the Centers for Disease Control and Prevention (CDC) failed to gain traction with Senate Republicans, he turned to Susan Monarez, a career federal health official who has been leading the agency in an acting capacity since January.
Former colleagues told The Hill that Monarez is an effective leader who has championed data-driven work and diversity, which could make her an awkward fit for Health and Human Services (HHS) Secretary Robert F. Kennedy’s Jr.’s agency, which has sent mixed messages on the safety of vaccines, gutted diversity, equity and inclusion (DEI) programs, and questioned myriad public health orthodoxies.
Monarez is well-respected in scientific circles and unlikely to face any resistance when she goes before the Senate for a confirmation hearing, which has not been announced a month after her nomination. Trump pulled his nomination of former Rep. Dave Weldon (R-Fla.) on March 13.
But Monarez almost surely will face controversy in the job, which will require her to navigate the public health establishment on one side and Kennedy’s “Make America Healthy Again” movement on the other.
Brett Giroir, former U.S. assistant secretary for health and former acting Food and Drug Administration (FDA) commissioner, who worked with Monarez during the recent Trump transition, described her as “brilliant, data-driven and nonpartisan.”
“My sense is Dr. Monarez was chosen because HHS leadership understands she will provide an objective, data and science-driven assessment of prospective policy and operational changes that are currently being considered,” Giroir, now CEO of Altesa BioSciences, told The Hill.
Among those policy changes was Trump’s ban on DEI across the federal government, which led the CDC to pull down data and websites on topics like vaccines, sexually transmitted diseases and LGBTQ health. The Trump administration has also been accused of restricting CDC research and messaging with layers of oversight.
The CDC is already under heightened scrutiny for its central role in crafting divisive COVID-19 policies during the pandemic. Its response to any public health crisis under Trump — measles being an early test case — will face particular scrutiny given Kennedy’s history as a vaccine conspiracy theorist and critic of the agency.
Erin Smith, principal at Pont Advisory Group and a former colleague of Monarez at Advanced Research Projects Agency for Health (ARPA-H), said Monarez was uniquely equipped to perform the duties and balancing acts required of the job.
“When there’s a room of people talking about an issue or a problem or a crisis … she’s a person you want in the room,” Smith said.
“There aren’t too many people that have made it through so many administrations at such a high level. And so, every possible permutation of government process she has seen, and she has seen it across many agencies. So, her expertise in intergovernmental workings amongst agencies is probably second to none.”
Prior to her CDC nomination, Monarez was deputy director at the ARPA-H. Despite having a long tenure in the federal government, Monarez would be an unusual choice for CDC nominee, having neither worked at the agency prior to her nomination nor obtained a doctor of medicine degree. If confirmed, she would be the first CDC director in decades to not be a medical doctor.
During her brief time as head of CDC, there have been reports that she hasn’t pushed back on directives from the White House to remove certain health data websites. It’s also been reported Monarez has been attending leadership meetings at the CDC, though this may have to do with her new status as a nominee.
The Department of Health and Human Services did not respond when asked for comment by The Hill regarding reports that Monarez is no longer attending meetings.
Trump’s nominees to lead health agencies mostly have medical backgrounds, though they have also challenged the public health mainstream on issues, like COVID-19 lockdowns. A few gained wider fame through regular appearances on Fox News. Marty Makary, the commissioner of the FDA, who was a top surgeon at Johns Hopkins prior to his nomination, has raised eyebrows by increasingly echoing Kennedy’s skepticism of vaccines and their safety.
To those who’ve worked alongside Monarez, she is remembered chiefly as a strong believer in science and wildly enthusiastic about the potential for integrating new technologies such as artificial intelligence into health care.
“I think with her in this position, we’ve seen a lot of extremely unqualified people who maybe would undermine the mission and vision of some of these health agencies,” one former colleague who spoke on the condition of anonymity told The Hill.
“And Susan is someone who I very much trust to — even if she needs to be a team player in this position — I don’t think she individually, with full autonomy, is going to go out of her way to find opportunities to dismantle the CDC. I do not suspect that of her at all.”
Smith, the former ARPA-H staffer, said Monarez was particularly skilled at coordinating private industry partners to all move in the same direction through government regulatory processes.
“We were going to be working on things that — some of them are higher risk and won’t be successful but some of them will be very successful,” Smith said. “And the only way to operationalize scale and then commercialize [it] is if everybody is working together, and I think her ability to see that is not typically found in government.”
When asked to describe Monarez’s managerial style, Smith said she was “collaborative by nature and a scientist by training and has almost no ego.” Smith added that Monarez’s skills with organization and belief in innovation would make her a good fit for Kennedy’s “Make America Healthy Again” agenda.
Monarez’s public comments will be closely watched for any breaks with Kennedy, given what appears to be drastically different perspectives on public health. Kennedy has often been dismissive of studies and data that form the bedrock of U.S. health policy.
During one of Kennedy’s confirmation hearings, Sen. Bill Cassidy (R-La.) presented him with a study disputing any links between vaccinations and autism. Kennedy immediately pushed back, saying other studies support a possible connection.
Former colleagues did not recall Monarez ever expressing her views on vaccinations, though she was repeatedly described as one who would trust science.
Monarez’s former colleague who spoke on the condition of anonymity speculated she may be acting pragmatically in response to the Trump administration’s directives, trying to identify areas of compromise and strategically mitigating broader attacks on existing data.
This same source recalled Monarez strongly advocated for a Hispanic Heritage Month event to be hosted by ARPA-H. Monarez is not Hispanic, but her husband is.
“So I’m curious where all of that goes in this new administration,” they said.
