The United States Senate has confirmed Dr Erica Schwartz as the new director of the Centers for Disease Control and Prevention (CDC), bringing permanent leadership to a public health agency that has been gripped by political upheaval, plummeting morale, and a dramatic loss of staff. The Senate approved her nomination in a 51-44 vote on Wednesday, making the 54-year-old the 22nd leader of the Atlanta-based agency and its first confirmed director in nearly a year.

Schwartz — who holds both medical and law degrees and previously served as deputy surgeon general and in a leadership role at the US Coast Guard — is the third CDC director nominee under President Donald Trump in just 18 months. The first, former Florida congressman Dr David Weldon, never reached a Senate vote after his hearing was abruptly cancelled. His successor, Susan Monarez, was confirmed but fired in less than a month after administration officials said she was not aligned with the president's agenda. Schwartz's confirmation itself appeared uncertain after a Senate hearing last month, during which committee chairman Bill Cassidy raised concerns about whether she would be willing to resist pressure from Health and Human Services Secretary Robert F Kennedy Jr — a prominent figure in the anti-vaccine movement — if directed to act against scientific consensus. Cassidy later said he had spoken further with Schwartz and gained confidence in her.

The CDC has shed more than 3,000 employees — over a quarter of its workforce — through a combination of layoffs and resignations since Trump returned to office. Many departing staff cited frustration with vaccine-sceptical policies promoted under Kennedy that conflict with longstanding public health guidance. In the absence of a confirmed director, the agency's leadership has cycled through a series of acting officials and political appointees with limited public health credentials.

Schwartz now takes the helm as the US confronts its worst measles resurgence in three decades, falling childhood vaccination rates, and an ongoing cyclospora outbreak. Public health experts have expressed cautious optimism about her appointment, noting that she was Trump's choice and not Kennedy's — a distinction seen as meaningful given tensions between the two men's approaches. Dr Georges Benjamin of the American Public Health Association called for stability and a "steadfast commitment to science," while the National Public Health Coalition, representing current and former CDC workers, urged Schwartz to "protect public health workers, defend evidence-based guidance, and refuse any directive that would undermine public safety."

The confirmation fills one of several leadership vacancies across federal health agencies, with the posts of US surgeon general and FDA commissioner also recently without permanent heads. Whether Schwartz can restore trust in an institution whose credibility has suffered — a recent poll found only half of US adults trust its recommendations — will likely define her tenure.