How to Fix the CDC

With more than a million Americans dead from COVID-19, monkeypox in all 50 states, and polio likely to have been spreading for months unrecognized, one of the few uncontroversial observations about public health in the United States is that it is ailing. But accurate diagnoses of the problems with public health are essential, and some suggestions for reform have potentially deadly consequences. Getting the diagnosis right—and doing so quickly—is the first step toward restoring trust and saving lives.

The Centers for Disease Control and Prevention, the agency that I led during the Obama administration, has just released commitments to improve its ability to protect health and save lives. The CDC’s push for faster responses; clearer, simpler, and more consistent communication and public guidance; better and more timely data; and a culture focused less on publishing academic papers than on nimble action is a step in the right direction. These greatly needed and long-overdue improvements acknowledge many of the agency’s problems.

But even if the CDC’s proposed reforms; a health-care system that is not structured to provide consistent care to patients; lack of standardization across states for collecting and reporting anonymized data for disease detection and response; and a broad increase in political polarization that shrinks the space for nonpartisan action and organizations. White House actions under both Republican and Democratic administrations have undermined the CDC’s credibility, its freedom to speak directly to the media and public, and the public’s perception of its scientific independence.