Centers for Disease Control and Prevention Director Erica Schwartz | Future of Health Summit 2026

Measles Elimination Status and Outbreak Dynamics

• Losing elimination status depends on the duration of an outbreak, not case volume; status is at risk if an outbreak persists longer than 12 months.
• The Pan American Health Organization is reviewing US measles outbreaks to determine if endemic transmission has been established.
• The CDC has allocated over $100 million to state partners since the outbreak began to support vaccination, laboratory sequencing, and surveillance.
• Current case demographics show 17% of patients are under five, 42% are aged 5–19, and 41–42% are adults over 19.
• Transmission is concentrated in close-knit communities with low vaccination rates, including adults who relied on decisions made decades prior.
• Prevention strategies prioritize MMR vaccination for eligible populations, with specific isolation guidance for those who are pregnant or under one year of age and cannot be vaccinated.
• The CDC is deploying "casting" surveillance to help states identify local outbreaks with limited data, emphasizing that state agencies must lead engagement as trusted community agents.

Restoring Institutional Trust (Internal and External)

• CDC Director Dr. Mandy Schwartz identifies restoring trust with both the American public and CDC staff as a primary priority.
• Internal psychological safety at the CDC is described as being at an all-time low due to recent staffing changes and the October 2023 shooting of Officer Stone.
• To rebuild internal stability, the CDC is hiring permanent leadership for Chief Information Officer (CIO) roles and implementing a strategic 2027 hiring plan developed with staff input.
• External trust rebuilding efforts focus on scientific transparency and a shift from authoritative mandates to humble, two-way public dialogue.
• The Director plans to collaborate with the newly elected Congressional Doctors Caucus to find common ground on health policies despite partisan differences.
• Innovation priorities for 2027 include "bio-threat radar," wastewater surveillance, and metagenomics, with specific mention of Senator Kim's visit regarding these tools.

Leadership Dynamics and Policy Conflicts

• Dr. Schwartz meets daily with Secretary Robert Kennedy at 10:00 AM to discuss agency-wide issues alongside Dr. Bhattacharya, Dr. Oz, and FDA officials.
• Leadership styles differ: Secretary Kennedy is described as highly decisive and inclusive of diverse opinions, whereas Dr. Schwartz describes herself as more indecisive and insular.
• Disagreements with the Secretary occur regularly but are handled privately; decisions are made based on the weight of evidence, sometimes favoring the Director's view and sometimes not.
• A specific disagreement occurred regarding the "340B issue," involving CDC, CMS, and HRSA, which the Secretary resolved after gathering all input.
• Dr. Schwartz confirms she has never met with new Chief of Staff Stephen Miller.
• Regarding the executive order on safer childhood vaccines, the task force report was due November 8th but remains in clearance; it will be submitted to the reconstituted Advisory Committee on Immunization Practices (ACIP).
• The ACIP reconstitution is pending an appellate court ruling; a federal register notice for new members has been issued to prepare for immediate action if the court rules in favor.

Global Health and Respiratory Virus Trends

• The CDC is responding to a deadly Ebola outbreak in the Democratic Republic of Congo (DRC) with a case fatality rate of 48%.
• Response efforts in the DRC are hindered by regional disruption but have successfully improved contact tracing numbers from initially low levels to approximately 25 contacts per case.
• The CDC and Africa CDC are providing daily support and monitoring the DRC's situation through the Emergency Operations Center.
• Current US respiratory virus trends show rising influenza cases, but decreasing COVID-19 and RSV rates, with RSV currently at an all-time low.
• A new surveillance tool, comparable to weather radar, allows the public to check zip-code-specific trends for influenza, COVID-19, and RSV to make informed healthcare decisions.