President Donald Trump has nominated acting CDC Director Susan Monarez to permanently lead the Centers for Disease Control and Prevention (CDC). If confirmed, she would be the first non-physician to hold the role and the first director who would require a Senate approval under a 2023 law. However, what is even more important is to know what it really means for public health in the US?Who Is Susan Monarez?She served as an interim CDC director since January and has a background in microbiology and immunology. She also holds a doctorate from the University of Wisconsin-Madison and has conducted postdoctoral research at the Stanford University School of Medicine. Unlike the previous CDC directors who were physicians, Monarez has built her career in science policy and has worked in the Department of Homeland Security, the White House Office of Science and Technology Policy, and the National Security Council. Before joining the CDC, she was the deputy director at the Advanced Research Projects Agency for Health (ARPA-H) under the Biden administration. Monarez has been described by Trump as a "dedicated public servant" with a focus on innovation and transparency. However, her tenure, even as an acting director has sparked controversy. Especially in the way the agency has been restructured and handled.What Health Challenges Do Lie Ahead?If confirmed, Monarez will face immediate public health crisis, including:A measles outbreak that has led to two deaths and over 300 cases in West Texas, New Mexico and OklahomaConcerns over the spread of bird flu, which has now also been detected in cows and catsAdditionally, the CDC is experiencing significant internal shifts, with the recent departure of eight high-ranking officials. Some of these resignations may be linked to Monarez’s leadership decisions, including layoffs of over 700 employees and the removal of certain health information from CDC webpages, particularly references to LGBTQ+ youth issues.What A Shift In CDC Leadership Mean?One of the biggest changes in the CDC's leadership structure is that Monarez's confirmation will require Senate approval. Before this, the CDC director was appointed directly by the president. However, this shift was introduced in 2023 and was backed by Republicans who argue that greater accountability was needed within the agency. Her nomination follows Trump’s withdrawal of his initial pick, former Rep. Dave Weldon, whose past views on vaccines made him a controversial choice. While Monarez’s stance on vaccines is not entirely clear, her nomination has been met with more approval from public health experts.Impact on the Health SectorMonarez’s leadership could signal major changes in public health policy. Under her interim tenure, the CDC temporarily delayed the release of the Morbidity and Mortality Weekly Report and postponed an immunization advisory committee meeting after a White House communications freeze. These actions raise concerns about political influence over CDC decision-making.Additionally, her collaboration with Health and Human Services Secretary Robert F. Kennedy Jr., known for his mixed messaging on vaccines, could impact national vaccination strategies. While Kennedy has publicly supported vaccines, his past statements have fueled skepticism.Public health leaders are watching closely. Dr. Georges Benjamin, executive director of the American Public Health Association, has praised Monarez’s scientific background but warned that a prolonged confirmation process could weaken her authority. “When you are not confirmed, you may be less willing to take tough positions,” he noted.Looking AheadIf confirmed, Monarez’s tenure at the CDC will be crucial in shaping America’s public health response. Her ability to manage outbreaks, navigate political pressures, and restore public trust in the CDC will determine whether her leadership strengthens or weakens the agency in the years to come.