Image: The Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia. Photograph: Bloomberg/Getty Images

Fourteen months after Robert F Kennedy Jr was sworn in as US health secretary, the country’s prime public health agency over which he presides is in a state of disarray.

Eighty per cent of the top director positions at the Centers for Disease Control and Prevention (CDC) stand vacant, with no permanent leader to drive policies affecting the health of millions of Americans. No one is in place to coordinate the agency’s day-to-day work fighting infectious disease, combatting heart conditions or screening for cancer.

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