Dr. Nancy Jane Cox, PhD (1948–2026)

Abstract

Dr. Nancy Jane Cox, PhD (1948–2026)

The international virology and public health communities mourn the passing of Dr. Nancy Jane Cox, an internationally renowned authority on influenza, a dedicated public servant, and a mentor to generations of scientists worldwide. She died from glioblastoma on 24 April 2026 in Atlanta, Georgia.

Born on 21 July 1948 in Emmetsburg, Iowa, Nancy was the eldest of six children. After graduating from a high-school class of only 18 students, she earned a scholarship to Iowa State University, completing her degree in 1970. She then received a Marshall Scholarship to the University of Cambridge, where she completed her PhD in Virology in 1975. In 1976, she joined the Centers for Disease Control and Prevention (CDC) in Atlanta, beginning what would become a transformative 38-year career in influenza science and global health. She served as Chief of the Influenza Branch and Director of the WHO Collaborating Center for Surveillance, Epidemiology, and Control of Influenza from 1992, and later as Director of the newly established Influenza Division from 2006 until her retirement in 2014.

Throughout her CDC career, Nancy was a driving force behind the modern US influenza prevention program. She strengthened national and global influenza surveillance, expanded laboratory capacity, and oversaw the development of vaccine-ready virus candidates. She also led national efforts to evaluate the annual impact of influenza vaccination and to expand vaccine uptake across the United States—initiatives that have protected millions of people.

Nancy's influence extended far beyond the United States. Recognizing influenza as a global threat requiring global solutions, she devoted her career to strengthening international preparedness. Under her leadership, the CDC Collaborating Center became a trusted partner within the WHO Global Influenza Surveillance and Response System (GISRS), and a committed supporter of National Influenza Centres around the world. She worked tirelessly with US government officials to secure sustained support for global surveillance, enabling more countries to contribute viruses and data essential for vaccine-strain selection and the early detection of emerging threats.

Nancy's leadership was equally important in shaping the WHO influenza vaccine strain selection process. She brought scientific objectivity and a cooperative spirit to the analysis of vast antigenic and epidemiological datasets, helping to achieve consensus during these often-difficult consultations. Her early embrace of genomic analysis and her strong support for adoption of antigenic cartography enabled more integrated data analysis across WHO Collaborating Centres and improved modelling of antigenic evolution, thus strengthening the evidence base for WHO vaccine recommendations.

Her international colleagues remember her as a dedicated and gracious leader whose scientific integrity was matched by deep empathy. For more than three decades, she helped guide complex global discussions on influenza policy, data sharing, and pandemic preparedness. Her guiding principle—to protect the health of all, preparing for the worst while striving for the best—helped shape the global architecture for managing influenza.

Nancy played a pivotal role during the emergence of H5N1 avian influenza in Hong Kong in 1997 and again during the widespread outbreaks beginning in 2003. She was among the first to recognize the pandemic threat and pressed for strengthened preparedness. She helped countries navigate difficult negotiations on virus access, benefit-sharing, and the responsibilities of member states, discussions that were often politically charged and extended well beyond scientific considerations. Her calm diplomacy and respect for all parties were instrumental in achieving harmony and ultimately establishing the modern WHO Pandemic Influenza Preparedness Framework and the strengthened GISRS.

Nancy was a key contributor to the establishment of GISAID, an effective platform for the open sharing and analyses of influenza sequence data (replacing separate databases), fostering collaboration, and facilitating greater inclusiveness in the provision of sequence data from GISRS labs. She served as chair and co-chair of its Scientific Advisory Council from 2008 to 2017, helping to shape a system that later proved indispensable during the COVID-19 pandemic.

As a founding member of the International Society for Respiratory Viruses (ISRV) she helped shape the Society's growth and evolution. Serving as a founding Editor and later as an Editorial Advisory Board Member of the society's journal Influenza and Other Respiratory Viruses, she contributed to the journal's scientific direction and reputation. She also played an important role in the development of the Options for the Control of Influenza meeting series, serving on Scientific and Organizing Committees from its earliest years, well before the series was incorporated into ISRV.

Nancy authored more than 278 scientific publications and received numerous honours, including recognition as one of Time magazine's “100 People Who Shape Our World” (2006), the Samuel J. Heyman Service to America Medal as Federal Employee of the Year (2006), the CDC Lifetime Achievement Award, and designation by Newsweek as one of 15 “People Who Make America Great.”

Her success stemmed not only from scientific excellence but also from her rare ability to translate laboratory findings into population-level policy. She moved effortlessly between discussions with virologists, epidemiologists, policymakers, and politicians, earning the trust of CDC Directors, WHO Directors-General, and government leaders who relied on her judgment and integrity.

Nancy was beloved by colleagues around the world, many of whom became lifelong friends. With her unwavering commitment to scientific rigor, collaboration, and service, she nurtured generations of young scientists who now contribute in leading roles across national and international arenas. Above all, she was devoted to her family, whose support and love were her constant foundation.

Her legacy endures in the global systems she helped build, the policies she shaped, the scientists she trained, and the countless lives protected through her work.

Joseph Bresee: conceptualization, writing – original draft, writing – review and editing. Alan William Hampson: conceptualization, writing – original draft, writing – review and editing. Wenqing Zhang: conceptualization, writing – review and editing. Masato Tashiro: conceptualization, writing – review and editing.

The authors have nothing to report.

The work did not require ethical review or approval.

The work did not involve human subjects and did not require patient consents.

The authors have no conflicts of interest.