Government career
Monarez was a Science and Technology Policy Fellow with the American Association for the Advancement of Science [6] during 2006–2007. [10] She worked as a science and policy advisor at Biomedical Advanced Research and Development Authority (BARDA) during 2006–2009,and at the Homeland Security Advanced Research Projects Agency (HSARPA) during 2009–2013. [11]
Monarez served as Assistant Director for National Health Security and International Affairs in the Office of Science and Technology Policy,and the Director of Medical Preparedness Policy on the National Security Council [4] during 2014–2016, [11] where her work included initiatives to combat antimicrobial resistance,expand the use of wearable technology for health monitoring,and improve pandemic preparedness efforts. [6] [12]
At the U.S. Department of Homeland Security,Monarez served as Deputy Assistant Secretary for Strategy and Data Analytics during 2016–2018, [13] overseeing research portfolios for BARDA and HSARPA. In this capacity,she also led international cooperative initiatives to foster bilateral and multilateral collaboration in health research and innovation. [6]
Monarez was the founding director of the Office of Planning,Analysis and Evaluation at the Health Resources and Services Administration [4] during 2018–2022. [13]
In January 2023,Monarez was appointed deputy director of the Advanced Research Projects Agency for Health (ARPA-H),where she led projects focused on applying artificial intelligence and machine learning to improve health outcomes,addressing healthcare accessibility and affordability,expanding mental health interventions,combating the opioid epidemic in the United States,addressing disparities in maternal health,and improving organ donation and transplantation systems. [6] [12]
Centers for Disease Control and Prevention
Monarez became Principal Deputy Director and Acting Director of the Centers for Disease Control and Prevention (CDC) on January 23,2025. Her leadership responsibilities at the CDC included overseeing responses to public health emergencies and emerging diseases. [12] [14]
Donald Trump announced her nomination as permanent Director on March 24,2025,after he withdrew his previous nomination of Dave Weldon. She was the first appointee to the position requiring confirmation by the Senate [15] [16] due to a provision in the Consolidated Appropriations Act,2023. [17] [18] Upon being nominated,she stepped down as Acting Director due to requirements of the Federal Vacancies Reform Act of 1998. [19] On July 29,2025,the U.S. Senate confirmed her 51–47 in a party-line vote. [20] Because she has a Ph.D. rather than an M.D. degree,she was the first director without a medical degree since 1953. [21]
On August 27,2025,the Department of Health and Human Services (HHS) stated in a post on X that Monarez was no longer CDC Director. It was reported that she was fired because she refused to support directives from Secretary Robert F. Kennedy Jr. on changes to vaccine policy,including for approvals for COVID-19 vaccines,and to fire her senior staff,and for recruiting Senator Bill Cassidy to intervene in the dispute. [22] [23]
On the day of the firing,attorneys Mark Zaid and Abbe Lowell,representing Monarez,stated that she had not actually been fired yet,and that she would not resign. [24] Later that day,White House Deputy Press Secretary Kush Desai announced via email that Monarez had been fired. [22] Zaid maintained that the firing remained invalid because,as a Senate-confirmed official,Monarez could only be fired directly by President Trump himself and not by other White House officials. [25] [26] However,by September 3,she was no longer trying to be reinstated. [27]
Following news of her ouster,at least four other CDC senior officials announced their resignations: [24] [28] [29]
On August 28,it was reported that the Trump administration was planning to appoint HHS Deputy Secretary Jim O'Neill as Acting CDC Director. [30]
On September 17,2025,Monarez told the Senate Committee on Health,Education,Labor and Pensions that she confirmed that she was fired because she did not preemptively commit to accepting CDC advisory panel recommendations and firing some career officials overseeing vaccine policy,thus confirming the earlier reports. [31] She believes that the true reason was holding the line on scientific integrity. [31]
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