The revolving-door leadership of the nation's top public health agency took another potential turn on Wednesday, as Dr. Erica Schwartz's nomination came before a U.S. Senate committee.
Schwartz, 54, is up for director of the Atlanta-based Centers for Disease Control and Prevention, which is charged with protecting Americans from preventable health threats.
Her career has largely been spent in military uniform, including in a leadership position at the U.S. Coast Guard where she oversaw the organization’s system of 41 clinics and 150 sick bays — as well as policies promoting vaccinations of service members. She later served as deputy surgeon general, where she helped lead uniformed medical and health professionals posted at the CDC and government health agencies that serve the general public.
The CDC long enjoyed a sterling international reputation but has been in turmoil since Trump returned to office last year. Largely due to layoffs and resignations, the agency has lost more than 3,000 employees, or more than a quarter of its workforce. Morale has plummeted as a succession of mostly temporary leaders have come and gone — the front office filled with political appointees, many of them with little or no training in medicine or public health.
“There’s still really good people who work there (at the CDC). They are doing their best to navigate choppy waters,” said Dr. David Margolius, director of Cleveland's health department and a leader in a U.S. coalition of big city health departments. But CDC no longer seems to the authoritative and communicative lead that it was on outbreaks and other public health emergencies.
“Basically everybody’s got to kind of choose their own adventure, as opposed to being led by a national public health department,” Margolius said.
CDC has had several leaders
The agency is overseen by Health Secretary Robert F. Kennedy Jr., who was a leading voice in the anti-vaccine movement before he was tapped to lead the CDC and other federal health agencies. Kennedy had promised not to change the nation's vaccination schedule. But shortly after taking office, Kennedy said he was going to investigate the childhood vaccine schedule and went on to attempt a substantial rewrite of vaccine recommendations for kids. Some of those efforts were put on hold earlier this year by a federal judge.
The administration's first pick to run the CDC was former Florida congressman Dr. David Weldon, but his March 2025 Senate confirmation hearing was canceled an hour before it was to begin. Weldon said at the time that he'd been told not enough senators were willing to vote for him.
The White House then moved on to Susan Monarez, who had been serving as the CDC's acting director. Monarez was confirmed by the Senate, but she was ousted in less than a month. Trump administration officials said she wasn't aligned with their agenda so they terminated her.
Several key CDC scientific leaders resigned in protest, saying Monarez’s dismissal dashed their hopes that a CDC director would be able to guard against political meddling in the agency’s scientific research and health recommendations.
Since then, there’s been a revolving door in agency leadership, with the short-term role of acting director being passed from one Washington-based HHS official to another. National Institutes of Health Director Jay Bhattacharya has been overseeing the CDC most recently.
Senators will also hear from nominee overseeing health emergency preparedness
In April, Trump nominated Schwartz, calling her “incredibly talented.” In a congressional hearing in April, Kennedy said he approved of the choice, but refused to commit to supporting whatever vaccine guidance she might issue.
Last month, Schwartz filed letters with the government that address her finances and potential conflicts of interest. She wrote that if confirmed, she will leave her current job with UnitedHealth Group, where she's making about $850,000 in salary and bonus money and cash out her stock options. She also will resign from the board of directors of Butterfly Network Inc., a Massachusetts company that makes ultrasound devices; from the board of Atlanta-based Aveanna Healthcare, a medical home care provider; and from the board of the Florida-based Searching for Solutions Institute.
Also at Wednesday's hearing, senators will consider the nomination of Sean Kaufman as the Assistant Secretary for Preparedness and Response, or ASPR. That job entails overseeing preparations and response to public health emergencies and disasters.
Last year, the Trump administration announced a plan to bring those responsibilities under CDC, but the dramatic HHS restructuring has not happened.
The assistant secretary's office is involved in decisions about funding next-generation vaccines against pandemic flu or other infectious disease threats. In postings on LinkedIn, Kaufman has made comments cheered by vaccine skeptics, arguing against hepatitis B vaccinations for newborns and saying he served as an expert witness to advocate for people who refused the COVID-19 vaccine.
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