Posted on 11/25/2025 12:44:18 PM PST by nickcarraway
Ralph Lee Abraham, MD, has a questionable public health track record
The CDC's internal email server now lists Louisiana physician Ralph Lee Abraham, MD, as the agency's principal deputy director. Until now, Abraham served as Louisiana's surgeon general. The above screenshot was provided to Inside Medicine on the condition of anonymity. While the news has not yet been publicly announced, an HHS spokesperson confirmed this on Tuesday.
'An Irresponsible Choice'
One source, a national public health expert who previously served in government and is familiar with Abraham's career, said that this would be "an irresponsible choice." He added, "He's a dangerous guy because he's very slick," referring both to his style and his experience as a Congressman from 2015-2021.
Here are some recent highlights from Abraham's career:
In February 2025, Abraham made headlines by announcing that Louisiana would end mass vaccination campaigns. While Abraham may not be a strict anti-vaxxer (he said that childhood immunizations are "important"), the announcement came the same day that Robert F. Kennedy Jr. was confirmed as health secretary -- not exactly a subtle way to audition for a top job within HHS.
The state of Louisiana, under Abraham's leadership, failed to alert physicians and the public about two whooping cough deaths and the largest outbreak in the state in 35 years for months, despite medical professionals' attempts to raise the issue.
A MedPage Today analysis found that out of around 12,000 practicing physicians in 2021, Abraham was the seventh highest prescriber of ivermectin in the state, a drug that by then had already been found to be ineffective in treating COVID. Abraham prescribed the medication 422 times in 2021, which meant that he was personally responsible for 1.1% of the state's ivermectin prescriptions. (In fairness, that pales in comparison to Texas physician Stella Immanuel, MD, who milled out 31,979 ivermectin prescriptions in 2021.)
As the opioid crisis became more apparent last decade, Abraham was found to be among the most active prescribers of the drug class. The Advocate in Baton Rouge, Louisiana, reported that "Abraham was in the top 0.2% in the number of Medicare Part D patients he wrote opioid prescriptions for in 2013, according to data from the U.S. Centers for Medicare and Medicaid Services."
While Abraham holds an MD, and presents himself as a "family physician," it appears that he is not board-certified in Family Medicine. He is still licensed to practice medicine, however.
One CDC employee I spoke to was philosophical about the news, saying, "I'll tell you, I heard way worse names floated," when I shared the name of the apparent pick. That scientist felt that, while Abraham's views were "probably pretty terrible," he at least has genuine experience running a major public health system.
"Look, I don't think any of our top leadership is up for the job. Who there has large organization management expertise?" the CDC employee asked. "They also lack subject matter expertise, for that matter, but that's another story."
Abraham's X/Twitter account follows 45 other accounts, including Secretary Kennedy. A notable omission? Sen. Bill Cassidy, MD (R-La.), the physician who chairs the Senate HELP Committee that confirmed Kennedy, and who has had choice words with Abraham.
Is Secretary Kennedy Leveraging Federal Law to Maintain Control of CDC? (That May Be What This Is About.)
Soon after Secretary Kennedy broke promises he had made to secure Senator Cassidy's decisive confirmation vote, President Trump's initial nominee for CDC director, Dave Weldon, MD, was hastily withdrawn. While it's never been corroborated, I've always felt that Cassidy's early regrets over his vote for Kennedy were what killed Weldon's nomination, as Weldon also had an uncomfortable track record on vaccine skepticism. Cassidy, who truly is pro-vaccine, did not want to repeat his mistake on his Kennedy vote with Weldon, or anyone else.
As I wrote last summer, I believe the confirmation of Susan Monarez, PhD, as CDC director was slow-walked by HHS because, by then, Kennedy had sorted out that Monarez was, in fact, also pro-vaccine. Drawing out Monarez's confirmation process left Kennedy with more power -- power that was lost when she was finally confirmed, but which he reclaimed once Monarez was forced out of the job just weeks later.
This set up a potential stalemate. President Trump needs a new CDC director. Kennedy likely does not want that person to be pro-vaccine. But Senator Cassidy, having learned his lesson precisely one vote too late, probably views pro-vaccine stances as a necessary condition for any future CDC director confirmation vote.
So, given the barrier Cassidy now seems to represent, what is Secretary Kennedy to do? Easy. Game the system by stalling.
To understand how long Secretary Kennedy can effectively control the CDC director position without another pesky confirmation -- in which I believe Senator Cassidy would, this time, do the right thing by holding the line for vaccines -- I spoke to Stanford Law Professor Anne Joseph O'Connell, PhD, JD, MPhil.
Here's how it could work out:
Since Kennedy fired Monarez, the CDC's acting director has been Jim O'Neill, a biotech executive installed to do what she would not -- Secretary Kennedy's bidding on vaccine policy.
But under the Federal Vacancies Reform Act, acting directors can only serve for 210 days. That means that the Trump administration can lean on O'Neill only until March. After that, a new acting director cannot be named unless a permanent director has been officially nominated. (The 210-day limit applies to the position, not the person, Professor O'Connell told me.)
Absent a permanent nominee, this means that 210 days after Monarez's firing, the job of acting CDC director would be broken up in two ways. Most duties would fall to the next person in line at the CDC -- in this case, the apparent new principal deputy director, Abraham. But by federal law, there are some duties that may not be delegated to a lower position in the agency, but rather, only upwards -- that is, to the HHS secretary. For example, it was for that reason that only Secretary Kennedy could sign off on recommendations from the CDC's Advisory Committee on Immunization Practices earlier this year.
However, the principal deputy director can serve indefinitely, and it's not a Senate-confirmed position. So, it's possible that with Abraham in place in the number two role, Secretary Kennedy and President Trump could run the clock on this for a long, long time. That's because the moment Trump nominates a permanent CDC director, the 210-day clock extends. That means that, say, in March, there could finally be a new nominee. At that point, Kennedy could simply swap in some other lieutenant (the delicious etymology of that word comes from the French, lieutenant, or "place holder") as acting director for the entire period during which the nominee is under Senate consideration, plus another 210 days. On top of that, this cycle can repeat twice (O'Neill is the first, because Monarez's confirmation last summer reset the game).
All of this means that Secretary Kennedy may be able to fully leverage the power he seeks at the CDC by having Abraham serve as principal deputy director in name only, giving him the tacit power to provide marching orders to his boss, whether it is O'Neill (now through the end of March) or someone else (the second permitted acting director placeholder installed after a new permanent nominee is named, which, again, could be anytime between now and March). So, it could be 2027 before President Trump once again faces the specter of a CDC without an acting director. But, even then, why would he care, if Kennedy and Abraham can assume all of the duties?
So, once again, Secretary Kennedy may have found a way to exert the most influence that he possibly can. He may not know much about science, medicine, or health, but he seems to know at least some of our nation's federal laws. Unfortunately.
Sen Bill Cassidy (R-LA) is going to try and sabotage.
A very balanced, experienced doctor, Dave Weldon MD - should have been the #1 at CDC and Cassidy blocked it.
I’ve got ivermectin, ivermectin cream, amoxicillin, doxycycline, azithromycin from an online pharmacy and all less expensive than buying them from a U.S. pharmacy with my Anthem Blue Cross insurance coverage - no prescription.
Because Cassidy gets money from Big Pharma?
Senator Bill Cassidy (R-LA)
FEBRUARY 13, 2021
“CASSIDY VOTES TO CONVICT PRESIDENT DONALD TRUMP
WASHINGTON – Today, U.S. Senator Bill Cassidy, M.D. (R-LA) voted to convict President Donald Trump on a single article of impeachment charging him with “incitement of insurrection”. Cassidy released the following statement after the trial concluded:
“Our Constitution and our country is more important than any one person. I voted to convict President Trump because he is guilty,” said Dr. Cassidy.”
What’s wrong with prescribing ivermectin? It’s been very valuable and has saved many lives. It’s been used for decades with minimal side effects. William Cambell, won the Nobel in 2015 for discovering it.
I see from his Faust Files Dr Faust supports gender affirming care for minors. In laymen’s term that is called cutting off body parts, and trying to make them some part that they regret cutting off later as it doesn’t work like the real thing.
Ivermectin was around long before that.
Ivermectin, ‘Wonder drug’ from Japan: the human use perspective
https://pmc.ncbi.nlm.nih.gov/articles/PMC3043740/
“...One CDC employee I spoke to...”
Okay, who? The janitor, maybe?
wy69
y’all just shut up and trust whoever is in charge of “The Science”
“the seventh highest prescriber of ivermectin in the state, a drug that by then had already been found to be ineffective in treating COVID.”
Funny, I took ivermectin when I caught COVID and it worked!
Bkmk
You are confusing the date of the Nobel with how long the drug has been available. Ivermectin was available years before Campbell received the Nobel.
In 1975 Dr. Campbell was at Merck Labs reviewing drugs that might be effective for humans. The clinical trials for humans didn’t begin until 1981. Sometimes it takes many years for a researcher to be honored with a Nobel.
A MedPage Today analysis found that out of around 12,000 practicing physicians in 2021, Abraham was the seventh highest prescriber of ivermectin in the state, a drug that by then had already been found to be ineffective in treating COVID. Abraham prescribed the medication 422 times in 2021, which meant that he was personally responsible for 1.1% of the state's ivermectin prescriptions. (In fairness, that pales in comparison to Texas physician Stella Immanuel, MD, who milled out 31,979 ivermectin prescriptions in 2021.)
No Sale, MEDPAGE.
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