HHS Updates

Monarez in, Prasad out, and HHS Task Force News

From the CDC:

Congratulations to Dr. Susan Monarez, PhD, on her Senate confirmation as the 21st Director of the Centers for Disease Control and Prevention. She brings decades of distinguished experience in health innovation, disaster preparedness, global health, and biosecurity to @CDCgov Dr. Monarez will lead @CDCgov’s efforts to prevent disease and respond to domestic and global health threats, advancing @SecKennedy’s mission to Make America Healthy Again.

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I don’t know Dr. Monarez, but I do know Sec. Kennedy - I trust him, and he has placed his trust in her.

Dr. Monarez was the interim director of the CDC early this spring. As I have been told (not officially verified, but I have no reason to believe it isn’t true), she immediately began changing the culture at the agency, insisting on transparency and the release of scientific data, including data on the mRNA vaccines, to outside scientists to evaluate, including with the use of AI. People who would not comply were let go. Furthermore, she has led teams using AI, which is one of her areas of expertise.

I do know that the government has to understand and even embrace AI, and provide leadership and standards for managing its role in public health and medicine effectively. The risks associated with AI must be managed - and there are risks. We need leaders who understand the risks and can still utilize AI to our advantage. There is an ever-creeping public health mindset that mandates and insurance-driven health protocols are the way to control populations. This mindset has to end. Yet, the use of AI in protocol-driven medicine is real. So, there is a real tension there that has to be carefully navigated.

I am hopeful that Dr. Monarez will work towards this goal. But the truth is that there is little information about her. She worked for ARPA-H, which has a dark side, but she also has extensive experience with AI, which is a positive, as she hopefully understands the risks and benefits. She is known for having globalist leanings and sympathies. That could be a problem. The upside to her CV is that she has proven that she can manage teams and large governmental administrations, although none as large as the CDC.

I know many think that AI is evil and has no place in government. But that position is untenable. AI is here. Companies are using it. The government is using it. The government must both utilize this technology and provide a regulatory framework for corporations using AI, particularly in healthcare.

We have to control AI, and not let it control us.

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All that said, the CDC has been a hot mess for at least two decades, if not longer. Changing the culture of that organization and returning it to its original mission, which was infectious disease, will be a challenge.

The original mission of the CDC, founded as the Communicable Disease Center in 1946, was to prevent the spread of malaria in the United States.

The CDC began taking on issues beyond infectious diseases in the 1970s, expanding its mission to include areas such as environmental health, occupational safety and health, nutrition, smoking, oral health, cancer, health education, family planning, birth defects, and injury prevention. This was accelerated in the 1980s and 1990s.

There are two different bills currently working their way through Congress to stop the mission creep of the CDC.

• FY 2026 Budget Proposal & "One Big Beautiful Bill":
  The President’s FY 2026 budget and related congressional budget bills propose a fundamental overhaul of the CDC’s mission. These proposals would significantly cut the CDC’s budget by nearly fifty percent, eliminate entire centers - including the Global Health Center and the National Center for Injury Prevention and Control, and drastically reduce funding for programs related to chronic disease, primary care, mental health, and environmental health. The CDC’s scope would be narrowly focused on:

  • Infectious disease surveillance,

  • Outbreak investigations,

  • Preparedness and response,

  • Maintaining the nation’s public health infrastructure.
    Programs relating to diversity, equity, and inclusion (DEI) and broader public health efforts would be ended or moved outside of the CDC. At least $1 billion is proposed to be redirected to a new Administration for a Healthy America12.

• Senate Bill S.999 (119th Congress, 2025-2026):
  The “Public Health Improvement Act” was introduced in the Senate in March 2025. Its core objectives include reforming the CDC, limiting the scope of its public health authorities, and focusing its activities on traditional infectious disease roles.

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Dr. Vinay Prasad is out.

The other big news is that Dr. Vinay Prasad, who was chosen in early May to lead the biologics and vaccines division (CBER) has left the FDA. He was on the job for less than three months. Prasad was also chosen as the U.S. Food and Drug Administration’s chief medical and science officer. Neither of these positions is Senate-confirmed.

Dr. Prasad always seemed an odd choice for the job - he lacked substantial prior regulatory experience before taking the CBER post. Frankly, DC is a rough and tumble place, and I am not sure he realized precisely what he was getting into.

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In other HHS news, there is chatter that RFK Jr. will “retire” the members of the Advisory Panel called the U.S. Preventive Services Task Force (the Task Force).

“The U.S. Preventive Services Task Force (USPSTF or Task Force) makes evidence-based recommendations about preventive services such as screenings, behavioral counseling, and preventive medications. Task Force recommendations are created for primary care professionals by primary care professionals.” -HHS

The “Task Force” plays a key role in deciding which preventive services, such as screenings and preventive medications, must be covered by most private health insurance plans under the Affordable Care Act (ACA), without any cost-sharing (meaning patients pay nothing out of pocket). Specifically, the ACA requires coverage of all preventive services that earn an “A” or “B” grade from the USPSTF. So, there is big money involved in their recommendations. Linked is the site that lists their current recommendations.

News reports indicate the Secretary is considering the removal/retirement of all 16 task force members, akin to his actions in restructuring the CDC Advisory Committee on Immunization Practices. This is in part due to its various recommendations, as well as many members who are considered “woke.”

For instance, just before leaving office, Biden’s HHS announced that Alicia Fernandez, MD, was appointed to the task force - she is a self-identified expert in population health and “health equity.” She also directs the Latinx and Immigrant Health Research Program at the UCSF Center for Vulnerable Populations, which generates actionable research to increase health equity. She lists her “Diversity, Equity, and Inclusion Champion Training” at the top of her bio.

Recently, the task force developed a formal Health Equity Framework to systematically consider race, ethnicity, sex, gender, and social risk factors to be used in all of their recommendation processes.

Quotes from the Health Equity Framework policy are quite “educational,” and yes, this document most definitely demonstrates more than just a little “wokeness”:

“Health equity is the absence of unfair, avoidable, or remediable differences in health and well-being among groups of people. Health equity, in contrast to health equality, goes beyond ensuring equal access to quality care for everyone. Health equity necessitates proportionate universalism (i.e., the resourcing and delivering of universal services at a scale and intensity proportionate to the degree of need) for all to achieve their full potential for health and well-being.”

“the USPSTF prioritized developing a “health equity framework” to guide its pilot work on incorporating health equity, race, and antiracism into its recommendations.”

“The Evidence Review should use inclusive terminology when referring to specific populations. While inclusive terminology is evolving, the USPSTF has a living guidance document with respect to inclusive language for diversity, equity, and inclusion. General principles focus on:

1) Using person-centered language (e.g., “people with obesity” rather than “obese people”)

2) Using inclusive terminology (e.g., “pregnant persons” rather than “pregnant women”)

3) Using specific terms when possible (e.g., “Black and Indigenous populations” rather than “diverse populations”)

4) Using the term used by the study; however, when terms are interchangeable, use the more inclusive term 18

5) Capitalizing proper nouns for racial and ethnic groups (e.g., “Black Americans” rather than “black Americans”)

6) Avoiding terms that subjugate the specific population being referred to (e.g., “non-White persons” or “subpopulations”)

When appropriate, expert reviewer(s) with a health equity lens should be included to review the draft Evidence Report. It may also be helpful for AHRQ to identify specific liaisons for each Federal partner with health equity expertise. The expert reviewer form can include tailored requests for reviewers with specific expertise and/or include guiding questions to elicit more meaningful feedback.”

The entire document, which is the template for all new recommendations by this important “Task Force”, is all about “equity.”

Health equity, as stated by the “Task Force” above, is based on the concept of universalism, which is just another word for socialism.

People need access to affordable healthcare and lifesaving care. These are worthy and essential goals. However, health equity is not that, and this ideology is not the answer for America.

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