American Nurses Association concerned over CDC shakeup

The American Nurses Association is expressing concern over the recent firing of Centers for Disease Control and Prevention Director Susan Monarez after she refused to step down.

Monarez, who had previously said that only the president had the authority to remove her, had reportedly clashed with HHS Secretary Robert F. Kennedy Jr. over the CDC's guidance on vaccines. 

After Monarez's termination, three senior CDC leaders, including CMO Dr. Debra Houry, submitted their resignations, according to The Wall Street Journal. 

Also submitting their resignations were Demetre C. Daskalakis, director of the National Center for Immunization and Respiratory Diseases; Daniel Jernigan, director of the National Center for Emerging and Zoonotic Infectious Diseases; and Jen Layden, director of the Office of Public Health Data, Surveillance and Technology, according to The Hill.

In front of the Senate Finance Committee on Thursday, Kennedy defended the HHS shakeups as "absolutely necessary," and said new blood was needed to remove officials with conflicts of interest, bad judgement and political agendas.

The ANA said these developments raise "critical questions" about the stability and independence of the federal agency. 

"Public confidence in federal health guidance hinges on agencies that operate free from political interference and grounded solely in science and evidenced-based practice," the ANA wrote.

WHAT'S THE IMPACT

The ANA said these changes could harm public trust in the healthcare system and potentially pose a direct safety risk. 

"The removal of the CDC Director and resignation of key leaders raises serious questions about our country's ability to respond to a public health crisis if it were to happen today," said ANA President Jennifer Mensik Kennedy. "There has been a lot of change but not a lot of change management. The amount of change without transparency and clear communication is whipsawing to healthcare professionals and the public at large. Americans deserve steady and consistent leadership at the helm of the CDC to safeguard their health, safety, the economy and national security."

These concerns are compounded, she said, by the abrupt removal of ANA and other liaisons to the Advisory Committee on Immunization Practices (ACIP). These exclusions, the ANA said, undermine transparency and balance in policy discussions.

"A strong ACIP must be reconstituted to ensure robust and balanced debate,” said Kennedy. “As the largest and most trusted segment of the health care workforce, nurses understand that public health and national security are interconnected as health crises can threaten a nation's stability, economy and national security. We saw this during COVID. A strong CDC is essential to safeguarding public health."

ANA said it's urging the administration to take immediate steps to restore consistent, balanced and stable leadership at the CDC. This would also include reinstating ANA and other liaisons to ACIP, and ensuring that advisory panels reflect balance, transparency and expertise.

THE LARGER TREND

Monarez had been on the job for less than a month when she was removed.

She had served most recently as acting director of CDC and deputy director for the Advanced Research Projects Agency for Health.

Monarez earned a Ph.D. in microbiology and immunology from the University of Wisconsin–Madison, where she conducted research on developing technologies aimed at the prevention, diagnosis and treatment of infectious diseases. She completed her postdoctoral research fellowship at the Stanford University School of Medicine.

About a week after Monarez was sworn in, a gunman opened fire outside the CDC's Atlanta campus, killing a police officer and striking six of the agency's buildings. 

Following the shooting, hundreds of current and former employees at the CDC and other federal health agencies wrote a letter to Congress and Kennedy saying the attack came as Americans' distrust of public health institutions grew and federal leaders politicized and touted health misinformation, according to The Wall Street Journal.