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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End of carouselAlso on the Editorial Board’s agenda
- The misery of Belarus’s political prisoners should not be ignored.
- Biden has a new border plan.
- The United States should keep the pressure on Nicaragua.
- America’s fight against inflation isn’t over.
- The Taliban has doubled down on the repression of women.
- The world’s ice is melting quickly.
Ihar Losik, one of hundreds of young people unjustly jailed in Belarus for opposing Alexander Lukashenko’s dictatorship, attempted suicide but was saved and sent to a prison medical unit, according to the human rights group Viasna. Losik, 30, a blogger who led a popular Telegram channel, was arrested in 2020 and is serving a 15-year prison term on charges of “organizing riots” and “incitement to hatred.” His wife is also a political prisoner. Read more about their struggle — and those of other political prisoners — in a recent editorial.
The Department of Homeland Security has provided details of a plan to prevent a migrant surge along the southern border. The administration would presumptively deny asylum to migrants who failed to seek it in a third country en route — unless they face “an extreme and imminent threat” of rape, kidnapping, torture or murder. Critics allege that this is akin to an illegal Trump-era policy. In fact, President Biden is acting lawfully in response to what was fast becoming an unmanageable flow at the border. Read our most recent editorial on the U.S. asylum system.
Some 222 Nicaraguan political prisoners left that Central American country for the United States in February. President Daniel Ortega released and sent them into exile in a single motion. Nevertheless, it appears that Mr. Ortega let them go under pressure from economic sanctions the United States imposed on his regime when he launched a wave of repression in 2018. The Biden administration should keep the pressure on. Read recent editorials about the situation in Nicaragua.
Inflation remains stubbornly high at 6.4 percent in January. The Federal Reserve’s job is not done in this fight. More interest rate hikes are needed. Read a recent editorial about inflation and the Fed.
Afghanistan’s rulers had promised that barring women from universities was only temporary. But private universities got a letter on Jan. 28 warning them that women are prohibited from taking university entrance examinations. Afghanistan has 140 private universities across 24 provinces, with around 200,000 students. Out of those, some 60,000 to 70,000 are women, the AP reports. Read a recent editorial on women’s rights in Afghanistan.
A new study finds that half the world’s mountain glaciers and ice caps will melt even if global warming is restrained to 1.5 degrees Celsius — which it won’t be. This would feed sea-level rise and imperil water sources for hundreds of millions. Read a recent editorial on how to cope with rising seas, and another on the policies needed to fight climate change.
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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.