President Joe Biden plans to pick former North Carolina Secretary of Health and Human Services Mandy Cohen to lead the Centers for Disease Control and Prevention after current director Rochelle Walensky steps down at the end of this month, according to a source familiar. 

The news was first reported by The Washington Post. 

Unlike Walensky, who came to her role as an infectious disease physician, Cohen would bring to the job a background working in federal agencies. But she is relatively new to the world of infectious disease. 

Cohen is an internal medicine specialist who was appointed to be North Carolina’s secretary of Health and Human Services 2017. During her five years at the agency, she shepherded the state through the COVID-19 pandemic, implemented the state’s Opioid Action Plan and helped pass Medicaid expansion in the state.

She left the spot in January 2022 and now works as CEO of Aledade Care Solutions and as executive vice president at Aledade, a primary care network. Cohen in 2020 was floated as a potential pick for HHS secretary under President Biden, but then-California Attorney General Xavier Becerra was selected for the job.

She has held senior positions at the Centers for Medicare and Medicaid Services during the Obama administration, including chief operating officer and chief of staff at the agency, and served as acting director of the agency’s Center for Consumer Information and Insurance Oversight, according to her LinkedIn profile.

Cohen worked closely with current White House Chief of Staff Jeff Zients during her time in the Obama administration.

“This isn’t a person coming in who has to get to know the key players in the White House,” noted Stephen Morrison, senior vice president at the Center for Strategic and International Studies who focuses on global health and studies trust in the CDC.

The White House kept the selection process very closed off, according to multiple sources, only involving top White House and HHS officials, along with few others.

Though the CDC director role is one of the few health agency leads that does not require Senate confirmation, Cohen will undoubtedly face congressional scrutiny, especially from Republicans. Public trust in the CDC steadily declined between December 2020 and April 2022, according to KFF, formerly known as the Kaiser Family Foundation.

“The CDC needs a cultural overhaul,” Senate Health, Education, Labor and Pensions Committee ranking member Bill Cassidy, R-La., said when asked about what he’d like to see in a new CDC director. “So you need somebody who is able to overcome the inertia of bureaucracy to complete such an effort.”

This summer will be critical for the agency as it lobbies Congress to increase its funding and authorities via two must-pass bills: the reauthorization of a pandemic preparedness measure that expires on Sept. 30 and fiscal 2024 appropriations. 

Walensky has advocated expanding the agency’s data-collecting authorities and capabilities as part of the upcoming must-pass bills. But it’s already looking unlikely that the agency will see a funding bump.

Georges Benjamin, head of the American Public Health Association, said it’s important for the CDC to stay on a mission during this time of transition and politicization.

“Trust comes when people know you’re going to do what you’re supposed to do,” Benjamin said.