Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services, and is headquartered in Atlanta, Georgia.


The agency's main goal is the protection of public health and safety through the control and prevention of disease, injury, and disability in the US and worldwide. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention, and educational activities designed to improve the health of United States citizens. The CDC also conducts research and provides information on non-infectious diseases, such as obesity and diabetes, and is a founding member of the International Association of National Public Health Institutes.


The CDC's current director as of 2023 is Rochelle Walensky. The director reports to the United States Secretary of Health and Human Services. Since 2020, the CDC has faced scrutiny for its handing of the COVID-19 pandemic. In 2022, following an internal examination, Walensky acknowledged "some pretty dramatic, pretty public mistakes, from testing to data to communications," and called for the reorganization of CDC.

Structure

The CDC is organized into "Centers, Institutes, and Offices" (CIOs), with each organizational unit implementing the agency's activities in a particular area of expertise while also providing intra-agency support and resource-sharing for cross-cutting issues and specific health threats.

As of the most recent reorganization in February 2023, the CIOs are:

• Director
• National Center for Immunization and Respiratory Diseases
• National Center for Emerging and Zoonotic Infectious Diseases
• Division of Global Migration and Quarantine[31]
• National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
• National Center on Birth Defects and Developmental Disabilities
• National Center for Chronic Disease Prevention and Health Promotion
• National Center for Environmental Health / Agency for Toxic Substances and Disease Registry
• National Center for Injury Prevention and Control
• National Institute for Occupational Safety and Health
• National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce
• Global Health Center
• Immediate Office of the Director
• Chief of Staff
• Office of the Chief Operating Officer
• Office of Policy, Performance, and Evaluation
• Office of Equal Employment Opportunity and Workplace Equity
• Office of Communications
• Office of Health Equity
• Office of Science
• CDC Washington Office
• Office of Laboratory Science and Safety
• Office of Readiness and Response
• Center for Forecasting and Outbreak Analytics
• Office of Public Health Data, Surveillance, and Technology
• National Center for Health Statistics

The Office of Public Health Preparedness was created during the 2001 anthrax attacks shortly after the terrorist attacks of September 11, 2001. Its purpose was to coordinate among the government the response to a range of biological terrorism threats.

History

Establishment

The Communicable Disease Center was founded July 1, 1946, as the successor to the World War II Malaria Control in War Areas program of the Office of National Defense Malaria Control Activities.


Preceding its founding, organizations with global influence in malaria control were the Malaria Commission of the League of Nations and the Rockefeller Foundation. The Rockefeller Foundation greatly supported malaria control,[10] sought to have the governments take over some of its efforts, and collaborated with the agency.

The new agency was a branch of the U.S. Public Health Service and Atlanta was chosen as the location because malaria was endemic in the Southern United States. The agency changed names before adopting the name Communicable Disease Center in 1946. Offices were located on the sixth floor of the Volunteer Building on Peachtree Street.


With a budget at the time of about $1 million, 59 percent of its personnel were engaged in mosquito abatement and habitat control with the objective of control and eradication of malaria in the United States (see National Malaria Eradication Program).


Among its 369 employees, the main jobs at CDC were originally entomology and engineering. In CDC's initial years, more than six and a half million homes were sprayed, mostly with DDT. In 1946, there were only seven medical officers on duty and an early organization chart was drawn, somewhat fancifully, in the shape of a mosquito. Under Joseph Walter Mountin, the CDC continued to be an advocate for public health issues and pushed to extend its responsibilities to many other communicable diseases.


In 1947, the CDC made a token payment of $10 to Emory University for 15 acres (61,000 m2) of land on Clifton Road in DeKalb County, still the home of CDC headquarters as of 2019. CDC employees collected the money to make the purchase. The benefactor behind the "gift" was Robert W. Woodruff, chairman of the board of The Coca-Cola Company. Woodruff had a long-time interest in malaria control, which had been a problem in areas where he went hunting. The same year, the PHS transferred its San Francisco based plague laboratory into the CDC as the Epidemiology Division, and a new Veterinary Diseases Division was established.

Growth

An Epidemic Intelligence Service (EIS) was established in 1951, originally due to biological warfare concerns arising from the Korean War; EIS evolved into two-year postgraduate training program in epidemiology, and a prototype for Field Epidemiology Training Programs (FETP), which began in 1980. The FETP is a large operation that has trained more than 18,000 disease detectives in over 80 countries. In 2020 FETP celebrated the 40th anniversary of the CDC's support for Thailand's Field Epidemiology Training Program. Thailand was the first FETP site created outside of North America and is found in numerous countries, reflecting CDC's influence in promoting this model internationally. The Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) has graduated 950 students.


The mission of the CDC expanded beyond its original focus on malaria to include sexually transmitted diseases when the Venereal Disease Division of the U.S. Public Health Service (PHS) was transferred to the CDC in 1957. Shortly thereafter, Tuberculosis Control was transferred (in 1960) to the CDC from PHS, and then in 1963 the Immunization program was established.

It became the National Communicable Disease Center effective July 1, 1967, and the Center for Disease Control on June 24, 1970. At the end of the Public Health Service reorganizations of 1966–1973, it was promoted to being a principal operating agency of PHS.

Recent history

It was renamed to the plural Centers for Disease Control effective October 14, 1980, as the modern organization of having multiple constituent centers was established. By 1990, it had four centers formed in the 1980s: the Center for Infectious Diseases, Center for Chronic Disease Prevention and Health Promotion, the Center for Environmental Health and Injury Control, and the Center for Prevention Services; as well as two centers that had been absorbed by CDC from outside: the National Institute for Occupational Safety and Health in 1973, and the National Center for Health Statistics in 1987
An act of the United States Congress appended the words "and Prevention" to the name effective October 27, 1992. However, Congress directed that the initialism CDC be retained because of its name recognition. Since the 1990s, the CDC focus has broadened to include chronic diseases, disabilities, injury control, workplace hazards, environmental health threats, and terrorism preparedness. CDC combats emerging diseases and other health risks, including birth defects, West Nile virus, obesity, avian, swine, and pandemic flu, E. coli, and bioterrorism, to name a few. The organization would also prove to be an important factor in preventing the abuse of penicillin. In May 1994 the CDC admitted having sent samples of communicable diseases to the Iraqi government from 1984 through 1989 which were subsequently repurposed for biological warfare, including Botulinum toxin, West Nile virus, Yersinia pestis and Dengue fever virus.


On April 21, 2005, then–CDC Director Julie Gerberding formally announced the reorganization of CDC to "confront the challenges of 21st-century health threats". She established four Coordinating Centers. In 2009 the Obama Administration re-evaluated this change and ordered them cut as an unnecessary management layer.


As of 2013, the CDC's Biosafety Level 4 laboratories were among the few that exist in the world. They included one of only two official repositories of smallpox in the world, with the other one located at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation. In 2014, the CDC revealed they had discovered several misplaced smallpox samples while their lab workers were "potentially infected" with anthrax.


The city of Atlanta annexed the property of the CDC headquarters effective January 1, 2018, as a part of the city's largest annexation within a period of 65 years; the Atlanta City Council had voted to do so the prior December. The CDC and Emory University had requested that the Atlanta city government annex the area, paving the way for a MARTA expansion through the Emory campus, funded by city tax dollars. The headquarters were located in an unincorporated area, statistically in the Druid Hills census-designated place.


On August 17, 2022, Dr. Walensky said the CDC would make drastic changes in the wake of mistakes during the COVID-19 pandemic. She outlined an overhaul of how the CDC would analyze and share data and how they would communicate information to the general public. In her statement to all CDC employees, she said: "For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations." Based on the findings of an internal report, Walensky concluded that "The CDC must refocus itself on public health needs, respond much faster to emergencies and outbreaks of disease, and provide information in a way that ordinary people and state and local health authorities can understand and put to use" (as summarized by the New York Times).

Type

Federal, Medical

Preceding agencies

Office of National Defense Malaria Control Activities (1942)

Office of Malaria Control in War Areas (1942–46)
Communicable Disease Center (1946–67)
National Communicable Disease Center (1967–70)
Center for Disease Control (1970–80)
Centers for Disease Control (1980–92)

Founding Date

July 1, 1946

Alternative Names

CDC, Centers for Disease Control

Parent Organization

United States Department of Health and Human Services