This post has been updated.
The Trump administration has named Georgia Public Health Commissioner Brenda Fitzgerald as the next director of the Centers for Disease Control and Prevention, one of the most crucial public health positions in the U.S. government given the agency's role in tracking and stopping infectious disease outbreaks nationally and globally.
Fitzgerald, 70, an obstetrician-gynecologist who has headed that state's public health department since 2011, will succeed Tom Frieden. He stepped down in January after serving for eight years, longer than any director since the 1970s. Anne Schuchat, a veteran CDC official, has been serving as acting director.
The new director is currently president-elect of the nonprofit group that represents the nation's public health agencies, the Association of State and Territorial Health Officials. She has strong ties to Republican leaders in and from Georgia, including Health and Human Services Secretary Tom Price and former U.S. House speaker Newt Gingrich. Fitzgerald, a Republican, ran unsuccessfully for Congress in 1992 and 1994 in her state's 7th congressional District.
In making the announcement Friday morning, Price said in a statement: "Having known Dr. Fitzgerald for many years, I know that she has a deep appreciation and understanding of medicine, public health, policy and leadership — all qualities that will prove vital as she leads the CDC in its work to protect America's health 24/7."
She takes the helm at the Atlanta-based agency at a critical time, as emerging disease outbreaks such as Ebola, Zika and antibiotic-resistant infections pose growing threats worldwide. Every president since Ronald Reagan has faced such threats, and experts say it is only a matter of time until at least one pandemic outbreak of an infectious disease confronts Trump.
“More than ever, CDC plays a critical role in safeguarding both U.S. and global health, providing technical assistance to partner countries to help prevent, detect and respond to future outbreaks before they spread, and scaling up immunizations and other critical public health interventions that save millions of lives every year,” noted David Fleming, an executive at PATH, an international health technology nonprofit. Fitzgerald “brings to this position decades of experience in managing public health policy and practice and a deep professional background in women’s health care,” he said.
Frieden, who was New York City's health commissioner before becoming CDC director, also welcomed the appointment. “It's a good thing that she has experience running a public health agency,” he said. “That’s critically important to being successful at CDC.”
Fitzgerald said in a statement Friday that she is "humbled by the challenges that lie ahead" yet "confident that the successes we’ve had in Georgia will provide me with a foundation for guiding the work of the CDC.”
Although the HHS secretary has underscored his commitment to global health and in May traveled to Liberia, the country hardest hit by the 2014-2015 Ebola epidemic, Frieden said “the big question for me is, will there be a 2019 budget for global health when the Ebola money runs out.” Should no new resources be allocated after about $600 million in emergency funds is gone, he warned, “CDC will have to retreat from the front lines of keeping Americans safe in more than a dozen countries.”
The administration is proposing a $1.2 billion cut — 17 percent — for the agency in fiscal 2018. If implemented, it would result in the lowest CDC budget in more than 20 years. Frieden and others have sharply criticized the reduction, which they say would make Americans less safe and healthy and would increase health-care costs. The proposal also includes deep cuts — more than $100 million — for emergency preparedness in the United States and globally.
Separately, both House and Senate proposals to replace parts of the Affordable Care Act call for eliminating critical funds for key public health programs that make up about 12 percent of CDC’s budget.
Public health organizations noted Fitzgerald's background as they praised her appointment.
“Her perspectives gained from clinical practice as well as serving as chief of a state public health agency will be crucial to her success” at CDC, said Jay Butler, ASTHO's president and chief medical officer for the Alaska Department of Health and Social Services.
Fitzgerald also received high marks from Georgia's academic public health communities for “bringing new research findings into practice,” said Tony Mazzaschi, senior director for policy and research for the Association of Schools and Programs of Public Health. At an April conference, he said “she was 100 percent engaged.”
Within CDC, Fitzgerald's actions will be watched closely to discern whether she will allow politics to overrule science — as other Trump administration officials have been accused of doing — and whether she will be able to advocate effectively in Washington. On hot-button issues such as abortion, she condemned graphic antiabortion ads aired by her GOP opponent in her first bid for elected office, saying the government had no business dictating abortion policy.
Fitzgerald was in private practice for 30 years before she was picked by Georgia Gov. Nathan Deal (R) to head the state's public health department when it became a stand-alone agency in 2011. It was in the spotlight in 2014 for rescinding a job offer to a California doctor who posted online sermons condemning homosexuals, Muslims and Darwin's theory of evolution, according to news reports.
As a state official, Fitzgerald has said that public health's three fundamental responsibilities are inspections, such as of food; disease surveillance and monitoring, such as for Zika; and emergency response. All those responsibilities “must be maintained and strengthened,” she said in an interview posted on ASTHO's website earlier this year.
In Georgia, she has encouraged programs to encourage language development among babies, pushed anti-obesity initiatives and helped coordinate state efforts during the Ebola outbreak.
The first U.S. health workers to became critically ill battling the Ebola epidemic in West Africa were airlifted to Emory University for treatment, setting off panic in the United States. Trump, not yet a presidential candidate, tweeted that they should be kept out of the country.
Fitzgerald holds a bachelor’s degree in microbiology from Georgia State University and a medical degree from Emory's School of Medicine. She trained at Emory-Grady Hospitals in Atlanta, and as an Air Force major she served at the Wurtsmith Air Force Strategic Air Command in Michigan and at Andrews Air Force Base in Washington.