The CDC is announcing a major reorganization aimed at changing the agency’s culture and restoring public trust


Big changes are coming at the United States Centers for Disease Control and Prevention, which recently celebrated its 75th anniversary as the nation’s lead public health agency.

CDC Director Dr. Rochelle Walensky met with the agency’s top leadership this morning to lay out her plans to overhaul the way the agency operates. She plans to overhaul the culture to help the agency act more quickly when responding to a public health crisis. She also wants to make it easier for other parts of the government to work with the CDC and wants to simplify and streamline the website to get rid of overlapping and conflicting public health guidelines.

Staff will be notified of the change by email. More than 12,000 people work at the agency, which is headquartered in Atlanta.

The changes will be aimed at improving the culture and restoring public trust after the agency’s admitted mistakes in response to the Covid-19 pandemic.

The reforms follow a period of review and introspection at the CDC. In April, Walenski announced that Jim McRae, associate administrator for primary health care at the Health Resources and Services Administration, would lead a month-long review of the agency’s Covid-19 response efforts. At the same time, she tasked three of her deputies with overseeing operations and recommending strategic changes. Walenski meets face-to-face with groups of employees as employees return to their offices after months of remote work.

The course correction comes after significant setbacks at the agency in response to the Covid-19 pandemic. The US had little capacity to test for the infection in the early months of the pandemic, largely because the agency released the wrong test to public health laboratories. This left the nation blind for months to the extent of the virus’ spread.

The agency was also criticized during the pandemic for issuing public health guidance that some saw as confusing and ineffective. Many also feel that it doesn’t move fast enough to react.

Walensky will bring former HHS Deputy Secretary Mary Wakefield to the CDC to oversee the reorganization.

Key organizational changes announced today include:

• The Division of Laboratory Sciences and the Office of Science will now report directly to the CDC director, a move aimed at improving accountability in providing timely information

• New Office of Intergovernmental Affairs – a hub where state health departments and other federal agencies interact with CDC

• A new executive board—reporting to the director—will set agency priorities, track progress and reconcile budget decisions with an emphasis on public health impact

• A new capital office that will increase diversity in both CDC’s workforce and add that perspective to its public health activities

Additional actions announced today include:

• CDC will create a new online mechanism for providing scientific information before publication

• The Agency will streamline and simplify its guidance documents and website.

Walensky also plans to ask Congress to give the agency new powers, including requiring jurisdictions to share their data. Currently, CDC depends on states and counties to do this voluntarily.

She will also ask for new flexibilities in the agency’s funding. Right now, when Congress appropriates money for the CDC, it must be spent on specific programs. This created more than 150 separate budget lines that fund the agency. This can be a problem when a public health emergency occurs. In 2014, when the Ebola outbreak began, Dr. Tom Frieden, then director of the CDC, had to borrow money from other parts of the federal government to respond.

“We literally didn’t have the money for airfare and per diem to send personnel into the field,” said Frieden, who was interviewed by Macrae for the review.

“I literally had 20 times more flex dollars as New York health commissioner than I did as CDC director,” Frieden said in an interview with CNN. Frieden now runs the nonprofit organization Resolve to Save Lives.

Some of those changes have already begun, including a reorganization of the agency’s communications operations.

Earlier this year, the CDC filled a long-vacant position when it hired Kevin Griffis, a veteran public affairs officer at the Department of Health and Human Services and Planned Parenthood, to lead communications efforts. Along with relaying health information to the CDC, part of his job is to manage the agency’s “risk communication and reputational issues,” according to the CDC’s website. The agency has not had a communications director in four years, according to a senior official familiar with the changes, who was not authorized to speak to reporters.

The final draft of the Macrae review will be published today. Key recommendations include:

• Share scientific discoveries and data faster

• Do a better job of translating science into practical, easy-to-understand policy

• Prioritize public health communications

• Reduce emphasis on publication of scientific findings for career promotion

• New training for agency staff so multiple people can fill the same role in public health emergencies

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