Washington’s favorite guessing game about who’s next out the door just took a twist, courtesy of Melania Trump.
White House chief of staff Susie Wiles stepped into a second job on Monday, Oct. 19, 2026, as co-chair of First Lady Melania Trump’s new women’s health task force, created by an executive order President Donald Trump signed in the Rose Garden.
The order, titled “Advancing Women’s Health to Improve Outcomes in All Phases of Life,” also establishes a Women’s Health Division inside the National Institutes of Health (NIH). Wiles, the first woman to serve as White House chief of staff and a veteran operative known around Washington as “the Ice Maiden,” will run the task force alongside Health and Human Services Secretary Robert F. Kennedy Jr. The appointment landed about a week after she was batting down reports that her grip on the West Wing was slipping.
Front Row, Aviator Sunglasses, One Pen
Wiles took the first seat in the front row and beamed as the president told the audience she had recently beaten breast cancer. “She’s tough. She’s a tremendous fighter,” Trump said. Moments later she stood on stage in her aviator sunglasses while both Trumps signed the order, and she accepted one of the signing pens from the president as a gift. She never took the microphone.
Wiles said in an interview that the appointment had been planned well in advance, and she credited the first lady with conceiving the effort and setting its strategy. It simply fit, she added, as the first female chief of staff who had been through cancer herself.
Melania Trump introduced the order before her husband spoke, telling the Rose Garden crowd that it sets a new standard for women’s health in the country. “Beginning today we will change the reality of women’s health,” she said. She also pressed the case for using artificial intelligence to speed medical discoveries and for making care affordable and available. Her office released a document it calls the First Lady’s Five Pillars of Women’s Health Innovation, and the task force was set to convene for the first time later that day.
A Press Secretary Hired Without Her
A week before the ceremony, Wiles was fighting reports that her tenure was in trouble after Trump hired Katie Zacharia as White House press secretary without her input, and as staffers argued over who would absorb the blame if Republicans lose the November midterm election. The president shut that down in public, ruling out any chance she would be fired and predicting a long run for her in the job. Zacharia, meanwhile, was ousted on Friday, Oct. 16, after just five days as press secretary.
The alliance with the first lady gives Wiles a formidable ally at a moment when much of her original circle has scattered. Campaign staffers who followed her into the building and have since left include former deputy chief of staff James Blair, former Office of Legislative Affairs head James Braid, former White House counsel David Warrington and former press secretary Karoline Leavitt. Deputy chief of staff Stephen Miller and communications director Steven Cheung remain in powerful West Wing posts.
Melania Trump reached out to Wiles while the chief of staff was in breast cancer treatment, and the two have a cordial relationship. Wiles announced in September that she is cancer-free. October is Breast Cancer Awareness Month.
The Clock Starts Ticking at NIH
The order gives NIH 90 days to stand up the Women’s Health Division, which will not replace the agency’s Office of Research on Women’s Health, established in 1990, but will carry a broader mandate beyond research. It sets no specific funding goals.
Besides the two co-chairs, the task force includes the secretaries of war, labor, agriculture, education and veterans affairs, plus the heads of the Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA), and it will coordinate with federal agencies and programs, the administration said. The order revokes President Joe Biden’s March 2024 executive order on advancing women’s health research and a November 2023 memorandum that created a White House initiative on the subject. Conditions flagged as needing more study include Alzheimer’s disease, endometriosis, polyendocrine metabolic ovary syndrome, infertility, maternal health, menopause, osteoporosis, heart disease, stroke, fibroids and chronic pain.
The initiative grew out of a run of meetings the first lady convened in the East Wing with physicians, outside experts and Health and Human Services officials, and she shaped the order in consultation with Kennedy and the president. Trump, for his part, detoured into unscripted commentary on the White House renovations — including the patio stone now covering what was once the Rose Garden lawn — before steering back to the subject at hand. The event came weeks before the Nov. 3 elections, with his approval ratings sagging, including among women: about 4 in 10 independent women supported him in the 2024 election, a figure that fell to roughly a quarter in the opening months of this midterm year, according to AP-NORC polls.
Wiles returned to the subject on social media after the ceremony, writing that the work is personal to her, that her own experience with breast cancer taught her what catching the disease early and getting good care can mean, and that she is grateful to both Trumps for taking up the cause.