CDC director worries about impact of budget cuts

June 16, 2011

Thomas R. Frieden took over as the director of the federal Centers for Disease Control and Prevention in Atlanta in June 2009. Before moving to the CDC, Frieden, a physician with extensive experience with both communicable and noncommunicable diseases, served as commissioner of the New York Health Department from 2002 to 2009.

What are your priorities at the CDC?

I keep it pretty simple — to save as many lives as possible. And we do that by using information to target problems, to identify solutions and to see if the solutions are being applied. So what I’ve done since coming here is identify six winnable battles, all of which have very substantial burdens of illness, and all of which we actually largely know what to do about, and all of which we are not yet doing adequately.

What’s been the biggest surprise for you since you took over?

Our laboratories, in a nutshell, are essentially fantastically qualified — and at very high risk. And they are at very high risk — both at CDC and at the state and local levels — because you have to run faster and faster to stay in place, as the Red Queen said to Alice. And our labs need to continue to upgrade their technology and their informatics capacity and their staffing capacity in order to keep pace with scientific advances. So to remain the world-class reference lab that we are and to continue to provide the essential services at the state level, we need to continue to invest in our laboratories.

What is the biggest challenge facing the agency?

CDC’s budget was cut by $740 million between fiscal ’10 and fiscal ’11. That’s an 11 percent reduction in our budget authority and the lowest budget authority CDC has had since fiscal 2003. We’ve had to make very difficult and painful choices that are resulting in program reductions and eliminations, reduction in the number of staff working on projects, reductions in dollars going out to state governments for prevention, for preparedness, for lead poisoning prevention, for asthma management. State and local governments have had to cut about 45,000 public health jobs in the past two years, and the CDC budget cuts may require them to reduce staffing by another 1,000 staff. So this, to me, is the biggest challenge.

How would you characterize the morale at CDC?

We did a restructuring when I first came in that eliminated two centers. I’m certain the people who were in those centers, many of those people, would feel that wasn’t a good thing. No one likes to see their unit go away. But, basically, we’ve been very attentive to what people’s concerns are. We’ve emphasized that people are doing a good job here. There’s a great deal of technical expertise. And where people have had concerns that we could address, we’ve addressed them. . . . A blog created because of employee concerns got used less and less and less and then got taken down . . . because there were no issues that were not really being addressed within the system. Not that everything’s perfect. But I think CDC has a very strong morale, and people are very committed to our mission and are doing their jobs well.

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