Acting Centers for Disease Control and Prevention (CDC) Director Jim O’Neill is quite a change from the recently departed Dr. Susan Monarez:
CDC's acting director tells staff to treat Americans 'as adults who can make their own informed decisions'
In an email, Jim O’Neill said the agency is experiencing "mission creep."
By Will McDuffie and Dr. Mark Abdelmalek - September 17, 2025In an email welcoming CDC staff back to the office weeks after a gunman fired bullets at the agency’s headquarters, acting Centers for Disease Control and Prevention Director Jim O’Neill wrote Tuesday that the agency had lost the trust of Americans and was experiencing "mission creep" that has led it to be too involved in Americans’ health decisions.
In the email, dated Tuesday and obtained by ABC News, O’Neill told CDC staff he hoped their "return is going smoothly" and noted "enhanced security and repairs to the Roybal campus" in Atlanta, Georgia.
He praised CDC's accomplishments from decades ago, including its combating of malaria and HIV, and noted its work this year on the measles outbreak in Texas and an Ebola outbreak in Africa.
But O'Neill made clear that Health and Human Services Secretary Robert F. Kennedy Jr. is now demanding a different approach from the CDC -- one by which the agency reduces its role in Americans’ lives.
"Mission creep has distracted us from our core mission over the years," O’Neill wrote. "Not every health decision is the government’s business, and CDC need not duplicate the work of other divisions."
O’Neill, the HHS deputy secretary whom Kennedy appointed to be CDC’s acting director after Susan Monarez’s dismissal last month, said the agency had "lost the American public trust and faith" during the pandemic but that HHS’ new leadership is "working hard to refocus and earn that trust back."
"Rigorous science, transparency about data and reasoning, and treating our fellow citizens as adults who can make their own informed decisions will be well received whenever we can offer them," he added.
Technically, the CDC only offers guidance and does not have the ability to mandate people’s behavior; things such as school vaccine mandates, for instance, are decided upon and implemented at the state level.
Fiona Havers, a former CDC official who worked on vaccine policy, told ABC News, “CDC has always treated Americans like adults by providing them with the science-based evidence and guidance they need to make their own decisions."
In his email, O’Neill urged staff to "think big. What is the 2026 equivalent of eradicating malaria? What might a CDC, unconstrained by WHO, look like? Where can I apply the principle of radical transparency to my work?"
President Donald Trump signed an executive order in January withdrawing the United States from the World Health Organization (WHO).
O’Neill’s email came on the eve of Monarez’s highly anticipated public hearing Wednesday in front of the Senate health committee, during which she alleged that Kennedy demanded that she approve "in advance" modified vaccine recommendations by an independent panel that Monarez testified were unsupported by scientific evidence or other data.
Monarez also testified in her opening statement that Kennedy directed her to "dismiss career officials responsible for vaccine policy without cause."
Monarez testified, "I was fired for holding the line on scientific integrity."
An HHS spokesperson later said Monarez’s testimony had "factual inaccuracies and left out important details," and described her dismissal as a consequence of her acting "maliciously to undermine the President’s agenda and was fired as a result."
The AP backgrounder on Jim O’Neill:
https://apnews.com/article/jim-oneill-cdc-kennedy-trump-vaccines-58fd24f678bf46ea6ec96a2b09f85ff4
Trump’s new CDC chief: A Washington health insider with a libertarian streak
By Matthew Perrone, August 29, 2025WASHINGTON (AP) — Jim O’Neill, a former investor, critic of health regulations and Health Secretary Robert F. Kennedy Jr.’s deputy, is taking control of the Centers for Disease Control and Prevention following a tumultuous week in which the agency’s director was forced out.
O’Neill was picked by President Donald Trump to be the CDC’s interim director, supplanting Susan Monarez, a longtime government scientist.
Monarez had been the CDC director for less than a month. Her lawyers said she refused “to rubber-stamp unscientific, reckless directives and fire dedicated health experts.”
O’Neill takes over an agency that has been rocked by firings, resignations and efforts by Kennedy to reshape the nation’s vaccine policies to match his long-standing suspicions about the safety and effectiveness of long-established shots.
O’Neill said Friday afternoon in a social media post that he looked forward to working with CDC staff and “announcing additions to the senior leadership in the weeks ahead.” He added that he would continue to serve as HHS deputy.
A former associate of billionaire tech entrepreneur Peter Thiel, O’Neill previously helped run one of Thiel’s investment funds and later managed several of his other projects. Those included a nonprofit working to develop manmade islands that would float outside U.S. territory, allowing them to experiment with new forms of government.
He has no training in medicine or health care and holds bachelor’s and master’s degrees in humanities.
A Washington insider on a team of outsiders
O’Neill has kept a markedly lower profile than Trump’s other top health officials, all of whom joined the administration as Washington outsiders. He’s also the only one with experience working at HHS, where he served for six years under President George W. Bush.
Those who know him say he’ll likely be tasked with trying to calm the situation at CDC — though it’s unclear what, if any, independence he’ll have from Kennedy.
“Jim O’Neill is a health care policy professional and I don’t think anybody can accuse him of being an RFK Jr. sock puppet,” said Peter Pitts, a former FDA official under Bush. “The question becomes whether the role of CDC director becomes a strictly paper tiger position, where the person only does what they’re told to by the secretary.”
O’Neill is not closely associated with Kennedy’s “ Make America Healthy Again ” movement and its efforts against food dyes, fluoride and ultraprocessed foods.
He was also not a major critic of public health measures during the pandemic, unlike Food and Drug Administration chief Marty Makary and other several Trump officials. Although O’Neill did use social media to criticize FDA efforts to stop the prescribing of unproven treatments for COVID-19, including the anti-parasite drug ivermectin.
O’Neill has pushed for less regulation
O’Neill has long-standing ties to the libertarian wing of the Republican Party, including Thiel, one of Trump’s leading supporters from Silicon Valley. Like Thiel, O’Neill has expressed disdain for many parts of the federal bureaucracy, saying it hinders advances in medicine, technology and other areas.
During Trump’s first term, O’Neill was vetted as a possible choice to lead the FDA, although his past statements about the agency raised alarms among pharmaceutical and medical technology executives.
In particular, O’Neill proposed doing away with FDA’s 60-year-old mandate of assuring new drugs are both safe and effective in treating disease. In a 2014 speech, O’Neill suggested drug effectiveness could be established after medicines hit the market.
Trump ultimately nominated Dr. Scott Gottlieb, a former FDA official and supporter of the agency’s regulatory approach, as commissioner.
Refusal to break with Kennedy on vaccines
After being nominated to the HHS post, O’Neill voiced his support for the federal government’s traditional system for overseeing vaccines — including the role of the CDC — while refusing to criticize Kennedy’s views on the topic.“I support CDC’s recommendations for vaccines,” O’Neill told Louisiana Republican Sen. Bill Cassidy at a confirmation hearing in June. “I think that’s a central role that CDC has. It’s mandated in law.”
In follow-up questions, Democrat Ron Wyden pressed O’Neill on statements by Kennedy downplaying the safety and effectiveness of vaccines to prevent measles and other diseases.
“Secretary Kennedy has not made it difficult nor discouraged people from taking vaccines,” O’Neill responded.
High-stakes vaccine decisions ahead
Within weeks, O’Neill could be asked to sign off on new recommendations from a CDC panel that Kennedy has reshaped with vaccine skeptics. The group is scheduled to meet next month to review vaccinations for measles, hepatitis and other conditions that have long been established on the government immunization schedule for children.
Traditionally, the CDC director signs off on recommendations from the panel. But Monarez was ousted after, among other things, she refused to automatically sign off the committee’s recommendations, according to Dr. Richard Besser, a former CDC acting director who spoke to her.
As an acting official, federal law limits O’Neill to no more than 210 days heading the agency before he must step aside or be formally nominated to the post.
Dr. Anne Schuchat, who served twice as acting CDC director, says there are essentially no limits on the powers of acting agency chiefs, beyond the time contraints.
“I was told, ‘You’re the director. Do what you need to do,’” Schuchat said.
Dueling health roles
Both of O’Neill’s roles at HHS and CDC are demanding, full-time jobs that would be extremely challenging for one person to do simultaneously, Schuchat said.
“But if the goal is to have an acting CDC director fulfill a predetermined decision about vaccines, it’s a different story,” Schuchat said.
It won’t help O’Neill that there was an exodus this week of four veteran CDC center directors, leaving the agency with few leaders who have a background in medicine, science or public health crisis management, she added.
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