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Internal Dissension Grows as CDC Faces Big Threats to Public Health

"We have a responsibility to really learn how we can do our jobs and accomplish our health protection mission in a world that has undergone some pretty profound changes," Gerberding said.

Founded in 1946, the CDC has grown into an $8 billion agency with more than 9,000 employees who play crucial roles in all aspects of public health: stanching the spread of AIDS, investigating disease outbreaks, protecting workplace safety, reducing domestic violence, vaccinating children and guarding against bioterrorists.

Centers for Disease Control and Prevention Director Julie L. Gerberding, right, denies that the agency is riddled with widespread discontent and demoralization. (David Brown -- The Washington Post)

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The main source of unhappiness at the agency stems from the Futures Initiative, the first major reorganization of the CDC in decades. Launched in June 2003, the plan is designed to transform the agency by shifting responsibilities, consolidating functions, fundamentally redrawing lines of authority and making the agency much more nimble in a crisis. One of the biggest changes would create four powerful coordinating centers intended to break down barriers that prevent the CDC's many centers, programs and offices from working efficiently together.

But the reorganization has dragged on for nearly two years, leaving many employees exhausted, disillusioned and impatient, Keegan and others said.

"Are we seeing efficiencies?" Keegan asked. "It doesn't feel more efficient. There's frustration that after two years we're still waiting for a payoff."

Some employees say much of the restructuring has been confusing, misdirected and counterproductive. One controversial change, for example, moves responsibility for vaccine safety out of the National Immunization Program.

"CDC folks are a very dedicated bunch . . ., [but] it's gone from dedication to make change to being aghast at the process and the changes being made," one senior official said. Among the 34 people interviewed for this article, this official and a number of other current and former CDC staff spoke on the condition they not be identified because of their intense loyalty to the agency and, in some cases, because they fear retribution.

"Growing Pains"

Other employees said the reorganization has been open, inclusive and positive.

"This is exactly what the agency needs to be doing," said Richard Goodman, a 27-year veteran who co-directs the agency's public law center. The complaints, he said, are just "growing pains."

But her critics said Gerberding has let the process drag on too long while jumping too quickly into the spotlight on high-profile issues, reeling from one crisis to the next, and relying too much on a close coterie of top aides.

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