The Trump administration’s “Make America healthy again” (Maha) agenda appears to be stalled as two of the government’s most influential public health positions sit empty.

The president has yet to nominate a permanent director for the Centers for Disease Control and Prevention (CDC), leaving an agency that has been plagued by turmoil for the past year without a leader. At the same time, Trump’s controversial pick for surgeon general, Casey Means, remains in limbo as her nomination stalls in the Senate.

The CDC has now been without a Senate-confirmed director for more than 210 days, the maximum length of time an acting head can manage an agency under federal law.

Jay Bhattacharya – who also runs the National Institutes of Health (NIH) – has served as interim chief of the CDC since February, and is expected to continue overseeing the agency through a delegation of authority by health secretary Robert F Kennedy Jr, according to statements from both the Department of Health and Human Services (HHS) and White House.

In a statement, HHS said that Kennedy and Chris Klomp, who serves as the director of Medicare and deputy administrator of the Centers for Medicare and Medicaid Services (CMS), are “working with the White House on the CDC director search by evaluating candidates that can further the Trump administration’s objective of restoring the CDC to its original mission of fighting infectious disease”.