The Washington PostDemocracy Dies in Darkness

Opinion The time has come for a major reset at the CDC

Rochelle Walensky, director of the Centers for Disease Control and Prevention, testifies on Capitol Hill on Sept. 14. (Sarah Silbiger for The Washington Post)
4 min

The covid-19 pandemic has been a strenuous trial for the Centers for Disease Control and Prevention, the nation’s premier public health agency. Its demoralized workforce is exhausted, its authoritative voice diminished, its data-gathering processes cumbersome. The agency’s funding is too inflexible to deal with challenges that demand rapid mobilization. The time has come for a major reset, which ought to be a high priority for the new Congress.

How the CDC reached this point is clear. Political pressure and manipulation by the Trump administration early in the pandemic played a role, as has deep polarization in American politics, which has fostered greater skepticism about science and debate over whether public health interventions infringe on personal freedom. But the trouble also lies in how the CDC is structured, funded and directed. These deficiencies can be fixed in the wake of the pandemic, and the CDC could come out of it stronger and more nimble. The nation needs a more robust CDC — not a smaller one, as former Food and Drug Administration commissioner Scott Gottlieb recently called for in a Post op-ed.

Director Rochelle Walensky announced a reform effort last year, acknowledging the mistakes of the past and pledging to make the agency more action-oriented. A reorganization toward this end was announced on Tuesday. This is a good start. As a new study by the Center for Strategic and International Studies declares, in today’s globalized world, a strong, reliable and effective CDC is indispensable to U.S. prosperity and security. To reach that goal, Congress and the administration will have to take the next steps.

The CSIS study, “Building the CDC the Country Needs,” was prepared by a task force led by Tom Inglesby, director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, and J. Stephen Morrison, senior vice president at CSIS and director of its Global Health Policy Center. Their report offers a serious and doable agenda for reform.

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They point to “fundamental and vexing gaps” in the CDC’s authority to acquire data, such as information on the spread of disease. Although the agency is “expected to move decisively at the earliest possible moment when signs of a dangerous outbreak emerge,” and cope with a fast-moving crisis either at home or abroad, it comes up against “five choke points.” One is that for every new disease, it must engage in time-consuming, politically sensitive negotiations to establish individual data-use agreements with each state and private entity, which can hamper its response. During the pandemic, the CDC found that critical data for tracking the virus was often scattered among different, incompatible databases, and it had difficulty persuading states to provide detailed personal information about vaccine recipients because of privacy concerns.

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Another choke point: The CDC lacks the contracting flexibility given to other federal agencies, and its funding is fixed in more than 160 individual budget lines, which inhibits its ability to move staff in an emergency. The CDC also lacks authorizing legislation, essential to clarify in law the agency’s mission, structure and funding. That can be rectified this year when Congress reauthorizes the Pandemic and All-Hazards Preparedness Act, which could easily include a new section on the CDC. If the CDC is expected to mount rapid responses like the Federal Emergency Management Agency does — and we think it should — it needs statutory authority.

Other priorities include preserving the CDC’s science staff. According to the new study, senior career ranks are aging, retirement is accelerating, and next-generation recruitment lags.

The CDC also has its work cut out to reestablish public confidence. President Donald Trump’s White House wrongly muzzled the CDC at the start of the pandemic. But the study found that the agency’s communications capabilities are “woefully underpowered” for today’s intense media environment. The CDC needs to be able to respond in real time and widely, including on social media, to uncertainty about outbreaks and disinformation about disease and vaccines.

The loss of public trust can also be remedied if Dr. Walensky and future agency chiefs demonstrate forceful leadership in a public health crisis. To that end, the Atlanta-based CDC needs a stronger presence in Washington, where policy is forged. The CSIS study also underscores the need to bolster the CDC’s large overseas operations, which are undervalued and underfunded, but remain vital in helping other countries and standing sentinel for the United States when a disease breaks out.

The CSIS report warns that the CDC has entered a “moment of peril.” If repaired and bolstered promptly, the CDC will be better able to tackle the real peril: disease and illness.

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Editorials represent the views of The Post as an institution, as determined through debate among members of the Editorial Board, based in the Opinions section and separate from the newsroom.

Members of the Editorial Board and areas of focus: Opinion Editor David Shipley; Deputy Opinion Editor Karen Tumulty; Associate Opinion Editor Stephen Stromberg (national politics and policy, legal affairs, energy, the environment, health care); Lee Hockstader (European affairs, based in Paris); David E. Hoffman (global public health); James Hohmann (domestic policy and electoral politics, including the White House, Congress and governors); Charles Lane (foreign affairs, national security, international economics); Heather Long (economics); Associate Editor Ruth Marcus; and Molly Roberts (technology and society).