The Centers for Disease Control and Prevention has long been the world’s most prestigious public health agency. The CDC led the global efforts to eliminate smallpox, combat HIV/AIDS, shift public perception/use of tobacco products and dramatically reduce dental care issues by promoting the use of fluoride in drinking water. Its most recent success has been reducing the incidence of opioid addiction, though we are still suffering from the most recent opioid epidemic.
Now, the CDC is under serious attack by the very people who are supposed to be responsible for improving the health of the nation. Secretary of Health and Human Services Robert F. Kennedy Jr. is leading this assault. An environmental lawyer and advocate with no background in health, Kennedy is a well-known vaccine critic. His confirmation as HHS secretary was highly controversial, but he was approved after giving assurances that he would follow the advice of his highly-qualified scientists. He has broken every promise he has made to members of Congress and the public.
Just this week, he attempted to oust CDC Director Susan Monarez, who was confirmed by the Senate on July 29 along party lines. Her status is now unclear. As a Senate-confirmed appointee, Monarez may only be fired by the president. While President Trump’s press secretary says this has happened, Monarez’s lawyers dispute it.
A well-functioning CDC is essential to ensuring the health and well-being that all individuals and communities in the United States want and deserve. Trump should reverse course on Kennedy’s precipitous actions by keeping Monarez and supporting a strong and science-based CDC. In addition to supporting the CDC, restoring Monarez will serve as a desperately needed check on Kennedy’s power. If Trump won’t oust Kennedy, as many — including my organization, the American Public Health Association — have called for, he at least needs to rein the secretary in and remind him of the commitments he made to the Senate during his own hearings.
Since becoming secretary, Kennedy has frequently articulated anti-vaccine ideology, promoted dangerous alternative therapies for measles, released a flawed report on children’s health and proposed a nonsensical reorganization of the Department of Health and Human Services that guts the CDC’s prevention programs, just to name a few.
He has also conducted indiscriminate firing of staff, proposed a 56% reduction in the CDC’s budget for FY 2026, and created massive inefficiencies in program operations by freezing existing funding. Staff have been prohibited from sharing routine health information with the public, and data systems have been altered. Important centers on chronic disease, injury prevention, and environmental health have been severely diminished. The future of important screening programs for breast and cervical cancer and newborn genetic diseases is unclear. Programs that address leading causes of death, like tobacco and gun violence, have been essentially eliminated.
Nevertheless, the expectation has been that the administration would work to strengthen the infectious disease capacity of the agency. However, actions by Kennedy and his newly hired support staff have undermined that promise. He fired the 17 members of the Advisory Committee on Immunization Practices, which makes evidence-based recommendations for vaccine utilization, and replaced them with hand-picked allies.
Two weeks ago, the CDC was fired upon by a lone shooter who was motivated by disinformation around Covid vaccination. Over 500 rounds were fired on at least four agency buildings. Tragically, a local police officer who responded to the shooting was killed. Kennedy’s response was both delayed and inadequate. Mental health and other supports for the CDC staff have also been inadequate. Even President Trump has yet to make a statement on the attack on a federal facility.
The secretary’s most extreme act occurred earlier this week when he abruptly forced out Monarez, after leading CDC for only three and a half weeks. Kennedy moved to remove Monarez because she would not sign off on the unscientific recommendation on the use of the updated Covid vaccines that the secretary supported. She also opposed Kennedy on his desire to fire several agency leaders. As CDC director, Monarez was responsible for approving the utilization of Covid vaccines based on the best available science. She was the last step in the therapeutic approval process to ensure FDA-approved therapeutics are used on the right populations. It is concerning that Kennedy, with no health background, wants to undermine the regulatory process designed to protect the public’s health.
In support of Monarez, and to protest the undermining of the agency, three senior CDC leaders resigned in protest: Deb Houry, chief medical officer and deputy director for program and science; Dan Jernigan, director of the National Center for Emerging Zoonotic and Infectious Diseases; and Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases. In addition, Jennifer Layden, director of the Office of Public Health Data, Surveillance, and Technology, also submitted her resignation. All four leaders have since warned America about the agency’s diminished capacity to promote the public’s health, as well as the ways that Kennedy is contributing to loss of trust. We should listen to them.
The CDC is becoming more dysfunctional every day. The rift that has developed between the department’s political leadership and the career professional staff has created an intolerable environment, which several career staff have described to me as “toxic.” In addition, the career staff have lost trust in the leadership of the secretary and believe they are unable to maintain their scientific independence. The changes in the way it is staffed, funded, and operates make it unable to protect the nation in its major function to respond to national security threats. Scientific recommendations from the CDC drive national standards for vaccine delivery and other public health best practices. CDC funds the vast amount of local public health programming for state and local public health practice and is the expert consultant for many rare diseases. Its laboratories are the reference laboratory for many medical and environmental tests. It also plays an essential role in the nation’s bioterrorism and environmental emergency response capability.
This is an alarming time for those of us who work in medicine. For the sake of the CDC and America’s health, Monarez needs to be reinstated at the CDC immediately.
Georges C. Benjamin, M.D., is executive director of the American Public Health Association.