Biden expected to name former NC health secretary as new CDC chief
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Key takeaways:
- Current CDC Director Rochelle P. Walensky, MD, MPH, is stepping down at the end of June.
- Experts want the new CDC director to have expertise in public health and experience at the federal level.
President Joe Biden is set to announce former North Carolina secretary of health Mandy K. Cohen, MD, MPH, as the next director of the CDC, according to multiple reports.
Current CDC Director Rochelle P. Walensky, MD, MPH, announced last month that she would resign the position at the end of June after 2 1/2 years on the job.
According to The Washington Post, which was first to report the selection of Cohen to succeed Walensky, a formal announcement of the pick is not expected until later this month.
Cohen, who is trained in internal medicine, is currently an executive vice president at Aledade — a physician-led accountable care organization focused on primary care — and chief executive officer of Aledade Care Solutions, the company’s health services unit.
She was appointed secretary of the North Carolina state health department in January 2017 and served in that position through the end of 2021, leading the state’s response to COVID-19. She also was former the chief operating officer and chief of staff at CMS, “helping to implement the Affordable Care Act’s health insurance exchanges and innovative new payment models,” according to her biography on Aledade’s website.
Following Walensky’s announcement last month, we began asking experts what qualities they would like to see in the next CDC director. Here are some of the responses:
Paul A. Volberding, MD, Chief Medical Editor of Healio | Infectious Disease News and professor emeritus of medicine at the University of California, San Francisco:
The qualities I desire in a CDC director are an experienced leader with excellent communication skills, previous work in the U.S. government in a policymaking position, career dedication to public health principles, respect in the academic medical community and experience in emergency response coordination.
Rutul Dalal, MBBS, MD, FACP, FIDSA, infectious diseases physician and incoming medical director of infectious diseases at Penn State Health, Eastern Pennsylvania Region:
During the past 3 decades, 37 new human pathogens have been identified as disease threats and the number of deaths from infectious disease agents has been rising due to new zoonotic agents, nosocomial agents, etc. We need a leader who can lead from the front and inculcate strategies that assure the public at large, assess appropriate health threats and develop policies to mitigate the health crisis as they come. Having said that, somebody with a background in microbiology and public health might help.
Lawrence O. Gostin, JD, director of the O’Neill Institute for National and Global Health at Georgetown University:
Above all, the CDC needs a leader who is widely respected and experienced in science and public health. Population health is the core skill required, not medicine. The new director also must have deep roots in state, tribal or local public health agencies. Forging strong relationships between CDC and public health agencies across America is essential. Finally, the director must have political skills and stature to stand up to pressure from the White House and Congress. A strong, well-funded, and independent CDC is the only way to restore public trust.
Peter J. Hotez, MD, PhD, DSc, dean of the National School of Tropical Medicine at Baylor University College of Medicine and co-director of the Texas Children Hospital Center for Vaccine Development:
Ideally the next CDC director would be a public health physician with experience running a public health agency, management experience around large organizations, federal government experience and specific expertise in combating infectious diseases and pandemic threats. Also, this person should be someone with outstanding communication skills. It may not be possible for a single individual to possess the full skill set, but close to it would help.
Keith S. Kaye, MD, MPH, Healio | Infectious Disease News Editorial Board Member and professor of medicine and chief of the division of allergy, immunology and infectious diseases at the Rutgers Robert Wood Johnson Medical School:
This person should be someone who is knowledgeable about infectious diseases and public health, but also can handle the political pressure that comes with the job. I would love to see continued focus on hospital-acquired infections, antimicrobial resistance, antimicrobial stewardship and pandemic and emerging pathogen preparedness.
Krutika Kuppalli, MD, Healio | Infectious Disease News Editorial Board Member and infectious disease physician:
The ideal candidate for the next director of the CDC should possess a unique set of qualities. They should have expertise in scientific communication to be able to effectively convey complex information to the public and have a strong background in medicine, public health and health policy. Experience with emerging infectious diseases and pandemic preparedness would be an asset. Finally, they should be forward-thinking and embrace innovative strategies to address emerging challenges so they can lead the nation toward a healthier and more resilient future.
Jeanne M. Marrazzo, MD, Healio | Infectious Disease News Editorial Board Member and director of the division of infectious diseases at The University of Alabama at Birmingham:
The new CDC director will need to possess a deep appreciation for the complexity of communicating rapidly evolving science under a high degree of scrutiny. While this is nothing new, the pressure has obviously escalated with the challenges posed by the pandemic and the not-infrequent inconsistency in messaging between federal agencies. It’s a critical job, so whoever takes it will need a lot of support from the ID community.
Gitanjali Pai, MD, Healio | Infectious Disease News Editorial Board Member, chief medical officer for the state of Oklahoma and infectious disease physician at Memorial Hospital and Physicians Clinic in Stilwell, Oklahoma:
The CDC director is a critical position that significantly impacts the health of not only Americans, but the entire world. As the head of this crucial public health agency, the CDC director should have expertise in the field of epidemiology and public health, an extensive understanding of disease prevention, surveillance and control strategies, as well as be swift at effective crisis management. They should have strong leadership skills to provide strategic direction, inspire and motivate the agency staff and make tough evidence-based decisions when needed.
The director should be able to guide the development and implementation of public health policies while managing complex public health programs, and effectively communicate complex public health information to not only the general population, but policymakers and the media — in a manner they can comprehend. Above all, the CDC director should demonstrate integrity, transparency, a commitment to the population's well-being and the promotion of health equity, while prioritizing evidence-based approaches and public health policies and recommendations grounded in rigorous scientific research.
Amira A. Roess, PhD, MPH, professor of global health and epidemiology at George Mason University:
Of course, they must have the training and experience to lead complex public health programs. The fact that this position has evolved into a high-profile political appointment has led to an overemphasis on politics over health, constant reorganization and low morale at the agency. The only way to protect the nation's health is to move to a career model where the director is selected by peers based on qualifications and experience, not political affiliation.
The job of a CDC director is increasingly complex given the multitude of crises our country faces. The director must be ready to respond to infectious diseases like influenza and mpox that are compounded by structural racism and disinformation. They face endemic firearm-related violence, the opioid/fentanyl crisis, exponential increases in mental health conditions and chronic conditions related to a culture and economy that promotes poor health all within a collapsing health care system designed to provide high quality care to the wealthiest. The CDC director must be able to communicate effectively and to recognize when communication experts should take the lead in messaging.
Raghavendra Tirupathi, MD, Healio | Infectious Disease News Editorial Board Member, medical director for Keystone Infectious Diseases/HIV, medical director of infection prevention for WellSpan Chambersburg & WellSpan Waynesboro Hospitals, and clinical assistant professor of medicine at Penn State University School of Medicine in Chambersburg, Pennsylvania:
The next CDC director should have a proven track record in effectively managing public health crises. Experience in responding to infectious disease outbreaks, coordinating emergency responses and implementing mitigation strategies would be highly valuable. The ability to lead and inspire teams, make difficult decisions and guide the organization through complex situations is essential.
The director should be able to provide clear direction, motivate staff and foster collaboration across different sectors and agencies within government and beyond, and have a deep understanding of pandemic preparedness and response.
The director should have a strong background in epidemiology and a firm grasp of data analysis and interpretation. They should be able to use scientific evidence and data to make informed decisions, guide public health policies and communicate findings effectively.
Clear and transparent communication is essential for a CDC director, especially during public health emergencies. They should also be adept at building public trust and countering misinformation, which is the need of the hour.
The next CDC director should possess excellent diplomatic and collaboration skills and should be committed to addressing health equity.
Also vital is the ability to adapt to changing circumstances and learn from experiences and incorporate those lessons into future preparedness efforts.
References:
- Aledade. Leadership. https://www.aledade.com/our-team. Accessed June 2, 2023.
- Diamond D, Sun LH. Biden plans to pick physician Mandy Cohen to lead CDC. Washington Post. June 1, 2023. Accessed June 2, 2023. https://www.washingtonpost.com/health/2023/06/01/cdc-director-mandy-cohen/.
- North Carolina Department of Health and Human Services. Dr. Mandy K. Cohen, MD, MPH. https://www.ncdhhs.gov/dr-mandy-k-cohen-md-mph. Accessed June 2, 2023.
- Secretary Mandy Cohen to step down as DHHS secretary, Governor Cooper selects current DHHS deputy secretary to lead department. https://governor.nc.gov/news/press-releases/2021/11/30/secretary-mandy-cohen-step-down-dhhs-secretary-governor-cooper-selects-current-dhhs-deputy-secretary. Published Nov, 30, 2021. Accessed June 2, 2023.
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Diamond D, Sun LH. Biden plans to pick physician Mandy Cohen to lead CDC. Washington Post. June 1, 2023. Accessed June 2, 2023. https://www.washingtonpost.com/health/2023/06/01/cdc-director-mandy-cohen/.
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