President Trump has nominated Susan Monarez for director of the Centers for Disease Control and Prevention (CDC). This has sent shock waves through the Make America Healthy Again (MAHA) community, as they were expecting a COVID-era celebrity to take up the reins.
To begin, while preparing this essay, out of the blue Health and Human Services Secretary Robert Kennedy Jr. called me to discuss the nomination of Monarez, so I have firsthand knowledge of the situation. Kennedy confided in me that he strongly supports her.
He described her as an administrative dynamo who, as acting CDC director, has been working closely with the Department of Government Efficiency (DOGE) and is doing an excellent job as acting director. For example, there were CDC employees who were obstructing access to important data and key Vaccine Adverse Event Reporting System (VAERS) information. Monarez acted promptly to remove these individuals or otherwise take actions required to obtain access to the necessary data. She did so quickly and efficiently.
In any case, don’t judge a book by its cover. If the MAHA agenda is to succeed, it will need people like Monarez to lead in key administrative positions. That is, it will require more than popular influencers. It needs people with years of high-level security clearance experience who understand the bureaucracy and how to navigate the rules and regulations so they do not get bogged down in the courts.
The energetic Monarez may be just what the doctor (or perhaps surgeon would be a better metaphor) ordered for treating a very sick CDC.
Who Is Dr. Monarez?
Monarez obtained her doctoral degree at the University of Wisconsin–Madison, where her research focused on infectious disease technologies, particularly those affecting low- and middle-income countries. She then did a postdoc at the Stanford University School of Medicine, focusing on infectious disease research.Despite this research background, PubMed only lists one publication, a recently published paper, under her name. So she is an administrator, not a researcher. Given her years in government, her skills in management are clearly what she excels at.
Monarez was a fellow at the American Association for the Advancement of Science. She then held roles in the Office of Science and Technology Policy and the U.S. National Security Council, where her work included initiatives to combat antimicrobial resistance, expand wearable technology for health monitoring, and improve pandemic preparedness efforts (that would include biodefense). She worked in the Obama, Trump 1.0, and Biden White Houses. During Trump’s first term, she held health technology and biosecurity roles, including positions at the Department of Homeland Security and the White House Office of Science and Technology Policy. So she was already known to the Trump chief of staff team of Susie Wiles.
At the Department of Homeland Security, Monarez served as deputy assistant secretary for strategy and data analytics, where she oversaw the research portfolios for the Homeland Security Advanced Research Projects Agency and the Biomedical Advanced Research and Development Authority. More spooky stuff.
In January 2023, Monarez was appointed deputy director of the Advanced Research Projects Agency for Health (ARPA-H), where she led initiatives to apply artificial intelligence and machine learning to enhance health outcomes. Under her direction, the ARPA-H program included research on health care accessibility and affordability, expanding mental health interventions, combating the opioid epidemic in the United States, and maternal health “disparities.” Much of her research has been focused on DEI-related research and health outcomes. However, I believe that it is likely her work with artificial intelligence-related solutions applied to public health that has propelled her through the ranks to be nominated first as acting director and then as director of the CDC.
Monarez became acting director of the CDC and acting administrator of the Agency for Toxic Substances and Disease Registry on Jan. 23 after being named as the agency’s principal deputy director. She was nominated on March 24 to be the new CDC director.
Will she survive the nomination process?
I predict that she will garner bipartisan, overwhelming support from the Senate and her nomination will be smooth sailing. Remember, she first worked for Obama and Biden, so the Democrats and the administrative state love her. There is a lot of speculation that she has strong ties to intelligence, and she worked in biodefense, so the Warhawks will adore her. As I wrote above, I predict support for her will be overwhelming from both sides of the aisle.
What About Kennedy?
I can’t see President Donald Trump blindsiding Kennedy on this nomination—it is too big.However, given her background, I can see why Kennedy might not object to her nomination and, given her progress and achievements to date as acting CDC director, why he would be enthusiastic about this appointment. He gave her a two-month tryout, and she passed. Remember always that the goal is getting the job done, not just rewarding people for having been right in the past.
Countless agency heads have come and gone in past administrations, and they have been predictably eaten alive by systems that they do not understand. This is what Washington has always counted on: Just wait it out, and the bureaucracy wins every time.
The Trump administration and Kennedy have a different plan in mind. As with Kash Patel at the FBI, as with OMB and many other agencies, this administration favors people with real experience and a determination to get the job done.
