Fourteen months into Robert F. Kennedy Jr.'s tenure as health secretary, the Centers for Disease Control and Prevention faces a leadership crisis that current and former officials warn is crippling the nation's disease-fighting capacity.
Eight in ten senior director positions at the CDC stand vacant, leaving no one permanently in charge of coordinating core functions from infectious disease response to cancer screening. The director role itself has been empty for eight months. Day-to-day operations have slowed dramatically, with staff unable to make routine decisions without approval from the health secretary's office, and productivity has hit what insiders describe as a standstill.
Daniel Jernigan, the former director of the CDC's national center for emerging and zoonotic infectious diseases, resigned in August and warned that this vacuum threatens American health security. "If another pandemic emerges, I fear the experience, leadership, and decisive action just won't be there," he said.
The staffing collapse began when Trump appointed Kennedy as health secretary last year. Since then, approximately 2,400 CDC employees have either been fired or quit, with an additional 300 stripped of duties on full pay for over a year. According to the CDC Data Project, directors of 20 out of 25 CDC centers have resigned or been forced out.
On Thursday, Trump moved to address some vacancies by nominating former deputy surgeon general Erica Schwartz as CDC director, subject to Senate confirmation. Two additional deputy director posts were also announced, but these appointments face an agency in profound disarray.
The consequences are already visible. Currently, no permanent director oversees the national center for immunization and respiratory diseases, the agency's vaccine division. The national center for emerging and zoonotic infectious diseases is also leaderless. A third infectious disease center operates with only an acting director. These units would handle critical responses to threats like a new Ebola outbreak or pandemic flu.
The damage extends to vaccine policy. Kennedy fired the entire 17-person advisory committee on immunization practices in June and replaced it with a hand-picked panel aligned with his vaccine skepticism. A judge temporarily blocked that decision as unlawful, leaving U.S. vaccine policy in limbo while new shots await review.
Dr. Debra Houry, who resigned as chief medical officer in August, testified to Congress that Kennedy had "repeatedly censored CDC science and politicized our processes." She noted that the unfilled chief medical officer position left no one to oversee the agency's nine national centers through a scientific lens or to safeguard the CDC's flagship publication, the Morbidity and Mortality Weekly Report, which has faced editorial chaos.
The national center for chronic disease prevention, which manages programs affecting millions of Americans for diabetes, heart disease, and cancer screening, lost about a third of its 1,000 staff. Its director was placed on administrative leave in April and later quit. Since then, three acting directors have cycled through with no permanent replacement.
Karen Hacker, the former director of that center, pointed to the Prams maternal health monitoring system as an example of critical work now undermined. The program tracks infant mortality and maternal health data, addressing a urgent need: the U.S. has one of the worst infant mortality rates among developed nations. The Trump administration labeled Prams as part of what it calls "gender ideology" and posted a disclaimer on its website stating the page "does not reflect reality." Hacker said the move left the nation "essentially flying blind" on pregnancy-related issues.
The impact on infectious disease surveillance is stark. The 2024-25 flu season saw 270 pediatric deaths, the highest number of children lost to influenza in a non-pandemic year since records began over two decades ago. Measles cases have reached a 30-year high.
A longtime CDC employee with decades of infectious disease experience described the paralysis plainly: travel requests for field work must now go to the health secretary's office and take months to process. Even trivial approvals cannot be granted by line managers whose positions are vacant. "There's nothing more demoralizing than not being able to do our work," the employee said. "Everything has ground to a halt."
Jay Bhattacharya, director of the National Institutes of Health, has been performing delegated CDC director duties, but reached a term limit last month. He now holds no official CDC title. The split focus on two massive health agencies has raised concerns he is spread too thin, especially with critical subordinate posts still unfilled.
Kennedy has long criticized the federal public health system as a sprawling bureaucracy in chaos. But officials who worked under him say the opposite is happening: his leadership vacuum is destroying the agency's mission clarity and creating what one former health adviser called "unregulated power" concentrated in political appointees with no institutional checks.
Author James Rodriguez: "The CDC isn't just understaffed, it's being dismantled from the top down, and the human cost will be measured in preventable deaths."
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