WATCH: Does America still need a Surgeon General?

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Tuesday, August 11, 2026

For more than a century, the office of the U.S. Surgeon General has evolved from its roots in the Marine Hospital Service into one of the nation’s most recognizable voices on public health — sounding the alarm on everything from smoking and AIDS to emerging health threats.

But today, the future and influence of that office are being tested.

Does America still need a Surgeon General?

In this episode of The Brief, George Gerbo traces the rise of the Surgeon General, the moments that transformed the office into the nation’s leading public health advisory voice, and the controversy surrounding Robert F. Kennedy Jr.’s leadership of the Department of Health and Human Services.

I strongly believe that the surgeon general must be independent and free to advise the nation on how it can prevent disease and promote good health. — C. Everett Koop, 2007

The Surgeon General was originally established in the 19th century for a very specific purpose. Congress created a position called the Supervising Surgeon in 1870 to oversee the Marine Hospital Service, which was a group of hospitals that cared for sick and injured sailors. Three years later, General was added to the end of the title, and in 1902, it became simply Surgeon General.

During this period, the Marine Hospital Service expanded beyond caring for sailors to addressing broader public health challenges such as infectious diseases, quarantine, sanitation, and medical research. The agency was eventually renamed the U.S. Public Health Service to reflect its growing national mission. Throughout the 20th century, the Surgeon General’s role evolved from managing a federal medical corps into serving as the nation’s leading health communicator, increasingly identified with educating Americans about major health threats.

Tonight’s CBS Reports begins with this historic announcement by the Surgeon General of the United States on January 11, 1964.

That transformation reached a turning point in 1964, when Surgeon General Luther Terry released a landmark report entitled Smoking and Health.

It is a judgment of the committee that cigarette smoking contributes substantially to mortality from certain specific diseases. — Luther Terry

Terry’s analysis fundamentally changed public attitudes toward tobacco, leading to warning labels on cigarette packages, restrictions on advertising, and decades of anti-smoking public health campaigns.

In the 1980s, C. Everett Koop became one of America’s most trusted public health voices during the AIDS epidemic.

Then, in the 1990s and early 2000s, those in the position focused on issues including obesity, mental health, opioid addiction, and vaping. But when confidence in government and public health institutions declines, the Surgeon General’s ability to shape public opinion declines as well. Which brings us to the current era of public health.

This afternoon we’re announcing new guidelines for every American to follow over the next 15 days. — President Trump

The COVID-19 pandemic intensified political polarization around science, public guidance, and government authority. Public trust in health institutions has also declined sharply. A June 2026 poll from the T.H. Chan School of Public Health at Harvard found only 50% of adults nationwide trust the CDC’s recommendations, a drop of 27% from the same survey last year.

The role of the Surgeon General has been vacant since Vivek Murthy left the position at the end of the Biden administration. Since then, the office has been managed by acting officials rather than a Senate-approved nominee. In that vacuum, one voice has risen.

Since becoming Health and Human Services Secretary at the beginning of President Trump’s second term last year, Robert F. Kennedy Jr.’s Make America Healthy Again initiative has made him and his department the face of keeping the nation healthy. Whereas the messaging from the Surgeon General has been traditionally serious and sometimes hard to digest, Kennedy leans into catchy taglines, including “Eat real food,” and even demonstrates public feats of strength, like doing push-ups and other exercises to try to encourage Americans to move.

Kennedy has long been a skeptic of vaccines, even though public health agencies and scientific consensus maintain that routinely recommended vaccines are extensively tested and provide benefits that greatly outweigh their risks. His vaccine stance ties in with the belief that the pharmaceutical and agricultural interests have way too much sway over lawmakers and policy. Another mark of his approach is that he isn’t afraid of publicly chastising officials.

At an event in West Virginia highlighting the state’s efforts to follow some of Kennedy’s recommendations, the secretary mocked West Virginia Governor Patrick Morrissey’s appearance and suggested he needed to lose 30 pounds.

Then when he’s lost 30 pounds, I’m going to come back to the state and do a celebration and a public weigh-in with him. — Robert F. Kennedy Jr.’

Kennedy’s outsized public persona has made him, if not the Surgeon General, the chief spokesperson when it comes to the nation’s health, which has caused speed bumps in the Trump administration’s efforts to fill the vacancy.

Since the start of his second term, President Trump has nominated three different women to be Surgeon General. The first was Janette Nesheiwat, but her nomination was withdrawn amidst questions about her education and credentials in May 2025.

Trump then nominated Casey Means for the post. Means earned her medical degree from Stanford but dropped out of her residency program. Means sat for a confirmation hearing in February and ran straight into headwinds from both Republicans and Democrats.

Means and Kennedy’s biggest opponent in this confirmation battle was the man who controlled the hearing, Senate Health, Education, Labor and Pensions Committee Chairman Bill Cassidy. Cassidy wanted assurance Means would base recommendations on evidence rather than her allegiance to Kennedy or ideological commitments.

The Surgeon General needs to be an effective and truthful communicator at a time when so many, for whatever reason, sow distrust and confusion. — Sen. Bill Cassidy

After the February hearing, Means nomination stalled, with Cassidy saying, “I can promise you there were multiple people on the committee who had decided to vote no.” On April 30th, Trump pulled Means from consideration to be Surgeon General.

Kennedy and other Trump allies accused Cassidy of sabotage, with RFK posting on social media that Cassidy “did the dirty work for the entrenched interests seeking to stall the Maha movement and protect the very status quo that has made America the sickest nation on Earth.”

The irony is that both Kennedy and Cassidy are actually advocating for the same thing. They want to rebuild trust in medicine. They differ, however, over how they believe that trust is earned. Cassidy argues trust comes from rigorous evidence and transparent science. Kennedy argues trust requires openly questioning institutions that many Americans no longer fully have faith in.

Perhaps the connection between these two schools of thought is the latest Surgeon General candidate, Nicole Saphier. The 44-year-old is a board-certified radiologist and director of breast imaging for Memorial Sloan Kettering Cancer Center at one of their facilities in New Jersey. A former Fox News contributor, she has expressed support for many MAHA priorities, including improving nutrition, addressing chronic disease, and examining environmental factors that may contribute to illness.

So will the Surgeon General role ever be filled?

Saphier’s nomination was submitted to the committee on May 11. Months later, at the time of this filming, a confirmation hearing still hasn’t been scheduled, as the committee works through nominations for CDC director and other health-related positions. With Congress headed out of town for its annual August recess, there’s a limited window in September for a potential Saphier confirmation hearing to take place before many senators head back to their districts to campaign. If Saphier doesn’t get a confirmation chance before then, it’s likely to remain vacant through the end of the year, with Stephanie Haridopolos continuing in her interim role.

The challenge of finding a new Surgeon General comes in a moment when the nation’s public health landscape is anything but quiet. Measles offers perhaps the clearest example. The U.S. recorded 285 confirmed cases in 2024. That was the last full year with a Senate-confirmed Surgeon General. 2,200 in 2025, and by late July 2026 had already surpassed the previous year’s total.

At the same time, health officials have responded to one of the country’s largest Cyclospora outbreaks in years, with more than 10,000 confirmed cases reported across dozens of states.

Those figures by themselves don’t explain why these outbreaks occurred, but they do illustrate the demands facing the nation’s public health leadership, and the importance of having a trusted national voice capable of communicating risk, interpreting scientific evidence, and helping Americans navigate rapidly evolving health challenges.

Read more:

America hasn’t had a surgeon general for 18 months — and does anyone care?
RFK Jr. appoints Stephanie Haridopolos as temporary surgeon general
Meet Dr. Nicole Saphier, Trump’s new surgeon general nominee
Trump pulls nomination of Dr. Casey Means for surgeon general, taps Dr. Nicole Saphier
Means’ surgeon general nomination is stalled as senators question her experience and vaccine stance
Surgeon general nominee faces sharp questions about vaccines, birth control and qualifications