Former CDC Director Shares the Hard Work Behind Outbreaks that Didn’t Happen

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It was a medical mystery worthy of Agatha Christie. Four people in four states had become sick with the same rare disease, melioidosis, caused by the bacteria Burkholderia pseudomallei. Two had died. None of the patients had met, and none had any history of travel outside the continental United States, let alone to the subtropical climates where the infection is endemic.

The intrepid gumshoes sent to track the culprit were investigators from the Centers for Disease Control and Prevention (CDC), as former CDC director and current Harvard Medical School Professor Rochelle Walensky told an audience at the George Washington University Thursday.

First, these investigators performed the genomic sequencing that linked the victims' symptoms to the same pathogen. Then, their exhaustive on-the-ground inquiries unmasked the innocent-looking killer: a lavender and chamomile aromatherapy room spray, manufactured in India and sold online and in some stores by Walmart. The findings led to a nationwide recall. The mysterious melioidosis cases stopped.

This is the kind of work public health workers do all the time, Walensky said-tangible, meticulous, lifesaving and unsung. Their proudest achievements are often invisible because they are preventative: an outbreak contained, a contaminated product recalled. "This is what we do in public health: We stay up all night and do the hard work so that something doesn't happen."

Walensky, who served as CDC director from 2021 to 2023, was the guest speaker at the Milken Institute School of Public Health's 2026 Gibbs Oration. The oration, focused on health leadership, is named for Frederick H. Gibbs, who in 1958 became the founder and first chair of what was then GW's Department of Health Care Administration. (GW's highly rankedMaster of Health Administration program is now housed in Milken Institute SPH.

Walensky "has led through amazing challenges in public health and has served our country in a way that we are truly indebted to," said Milken Institute SPH Dean Kelly Gebo, Walensky's longtime friend and colleague. "I can't think of a more important voice in public health at this moment."

A physician as well as a scientist, Walensky discussed her initial interest in public health, her unexpected path to the CDC, the lessons she learned there and the state of the field today in conversation with David Goldstein, president of GW's Public Health Student Association.

Walensky and Gebo became friends as medical school classmates and, upon their graduation, both undertook medical internships in inner-city Baltimore. It was 1995, and HIV-AIDS was killing tens of thousands of people in the U.S. every year. But the mid-1990s also saw a turning point in the battle against the disease: the emergence of a new class of antiretroviral drugsleading to significant improvements in life expectancy and quality of life. Unfortunately, not every patient had access to this groundbreaking treatment, which at the time cost about $15,000 a year.

"What I saw during that time…was this incredible intersection of really novel science and the people who couldn't afford to benefit from it, and that intersection was pretty stark for me," Walensky said.

Walensky's experience with HIV patients not only led her to become an infectious disease physician, but also sparked her interest in public health research. She joined Harvard University's faculty as a professor of medicine and eventually rose to become chief of infectious diseases at Massachusetts General Hospital. Taking the helm of a major agency like the CDC was "nowhere on [her] radar" career-wise.

But in 2020, shortly after Joe Biden won the presidential election, Walensky received a phone call asking her to consider the position of CDC director. Her first thought was "How could I possibly do this impossible job?" Her second thought was "How could you possibly not do this impossible job?"

Walensky likened the call to receiving a page from the code beeper that resident doctors carry. "You don't look at that code beeper when it goes off and say, 'Huh, I wonder if I can do this code...I wonder if I can save this life,'" she said. "You say 'I'm called…to do the best that I can.'" Walensky felt like her "code beeper for the nation was going off."

The COVID-19 pandemic had been raging for a yearwhen Walensky officially took over the CDC directorship in 2021. She was tasked not only with the colossal task of spearheading the nation's response under Biden, but also with communicating those measures and their rationales to the public.

"We in public health are underskilled in communication," Walensky said, and even extensive experience isn't always enough. She herself had been a CNN medical analyst throughout the first year of COVID, appearing on television about three times a week. She had spoken at national conferences. Even so, she felt she "would have benefited from more" communications experience and training.

Walensky's position also required her to make "hard, heavy decisions" with sweeping and often unpredictable downstream effects. As a hospital physician, she'd been tasked with treating the patients in front of her. At the CDC, every choice would have repercussions for people she would never have guessed were connected.

"Health touches everything," Walensky said. "I would make a health decision over here, and something would knock down at the Bureau of Prisons or in the Coast Guard." Over time, she learned to ask: "What can't I see?"

Reflecting on the proudest moments of her time at the CDC, Walensky did acknowledge some better-known achievements. "We put 700 million doses of vaccines into arms. I'm really proud of that-that's never been done before." But she also pointed to the massive effort of containing a measles outbreak among evacuees from Afghanistanduring Operation Allies Welcome, known only to a relatively small percentage of the public. "The proudest things are the things that you all have no idea about."

The public health outlook in the U.S. in 2026 seems bleak, Walensky recognized, given federal divestment from key resources, the spread of vaccine disinformation and a public health infrastructure long overdue for an overhaul. Vaccine-preventable diseases like measles and pertussis have reemerged as threats and are on the risenationally and internationally. "We are tackling yesterday's pandemics-we can't even think about tomorrow's," Walensky said.

But she also said public health mistrust is not as dire a crisis as it may appear. The overwhelming majority of Americans are still vaccinated and choose to vaccinate their children. Even a small thing like brushing one's teeth is a sign of trust in the country's public health infrastructure-after all, "you used the tap water this morning, and it's probably clean, and you probably feel safe," Walensky said. "So there is a remarkable amount of trust in public health."

Walensky's current initiative, the Vaccine Integrity Project, aims to fill some of the information gaps left by U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. disbanding the CDC's panel of independent vaccine adviserslast June.

During the Q & A, a graduating student asked Walensky if she still recommended careers in public service or government work. Without hesitation, Walensky answered, "Yes."

But during a time when those jobs are hard to find, she recommended new entrants to the workforce immerse themselves in fields they might not be comfortable with or fully understand-spaces that touch public health but use different language or hold different priorities. Exposure to "diversity of opinion [and] thought" is invaluable, Walensky said.

"We need public health innovators for the future," she said. "A rebuild is going to happen, and you all are going to be part of that solution."

Watch the full conversation here.