Brief Histories of U.S. Government Agencies Volume Two by Michael Erbschloe - HTML preview

Centers for Disease Control and Prevention

On July 1, 1946, the Communicable Disease Center (CDC) settled into the old offices of Malaria Control in War Areas (MCWA), located on the sixth floor of the Volunteer Building on Peachtree Street in Atlanta, Georgia, with a satellite campus in Chamblee, Georgia. Its primary mission was simple yet highly challenging: field investigation, training, and control of communicable diseases. Launched with a modest budget and fewer than 400 employees, most of whom were engineers and entomologists, the agency encouraged its staff to broaden their work within public health. In 1947, CDC made a token payment of $10 to Emory University for 15 acres of land on Clifton Road in Atlanta where CDC headquarters is located today. Field stations and laboratories were expanded and diversified, and employee training became an immediate task. The new institution would expand to include all communicable diseases, and would be the servant of the states, providing practical help whenever called.

Malaria Control in War Areas (MCWA), the predecessor to CDC, was established in 1942 to control malaria around military training bases in the United States. After World War II ended, Dr. Joseph W. Mountin of the U. S. Public Health Service's Bureau of State Services envisioned an agency that could support state and local health units in investigating and controlling communicable disease outbreaks, and in maintaining the nation's health through local measures. Building upon the work of the MCWA, the Communicable Disease Center (CDC) initially focused on fighting malaria, typhus and other infectious diseases. The agency was located in Atlanta, Georgia because the South was the area of the country with the most malaria transmission as well as the headquarters of MCWA. In the next 60 years, minor changes were made to the name (The National Communicable Disease Center, Center for Disease Control, Centers for Disease Control, Centers for Disease Control and Prevention), but the initials, CDC, have remained the same.

Through the years, CDC's work has expanded to include all infectious diseases, noncommunicable diseases, injury and environmental health, health statistics, and occupational health. Reporting today to the Department of Health and Human Services and working in collaboration with public health partners, CDC tirelessly leads the fight against known, new, and emerging diseases around the world. At the same time, CDC leads prevention efforts to reduce the burden of preventable and chronic diseases.

CDC is known as the nation's premiere health promotion, prevention, and preparedness agencies. CDC is globally recognized for conducting research and investigations and for its action-oriented approach. CDC applies research and findings to improve people′s daily lives and responds to health emergencies—something that distinguishes CDC from its peer agencies.

CDC works with states and other partners to provide a system of health surveillance to monitor and prevent disease outbreaks (including bioterrorism), implement disease prevention strategies, and maintain national health statistics. CDC also guards against international disease transmission, with personnel stationed in more than 50 countries.

CDC is now focusing on becoming a more efficient and impactful agency by focusing on five strategic areas: supporting state and local health departments, improving global health, implementing measures to decrease leading causes of death, strengthening surveillance and epidemiology, and reforming health policies.

(Link: https://www.cdc.gov/about/history/ourstory.htm)

Through CDC’s Antibiotic Resistance Solutions Initiative, the agency is transforming the nation’s capacity to further detect, respond, and prevent antibiotic-resistant threats across healthcare settings and in communities to protect Americans and save lives. This effort includes work to improve antibiotic use and misuse, a main cause of antibiotic resistance. At least 30 percent of antibiotics prescribed in outpatient settings are unnecessary.

• Emerging resistance. In 2016, five patients in the United States tested positive for the mcr-1 gene, which can make bacteria resistant to the last-ditch antibiotic used to treat resistant infections. In November, 13 cases of Candida auris, a drug-resistant fungus, were reported, adding to the list of emerging threats. CDC is tracking and identifying emerging resistant genes and infections caused by resistant microbes like these. By knowing where and how changes in resistance are occurring, we can inform solutions—like outbreak response, drug development, and diagnostic development—to contain spread and slow resistance.
• Healthcare-associated infections (HAIs). America is doing a better job at preventing HAIs, but more work is needed, especially in preventing antibiotic-resistant infections and their spread. CDC has found that 1-in-7 catheter- and surgery-related HAIs are caused by an antibiotic-resistant bacteria. That number increases to 1-in-4 infections in long-term acute care hospitals—facilities that treat patients who are generally very sick and stay, on average, more than 25 days.
• Resistance in the community. In 2016, CDC expanded the use of whole genome sequencing (WGS) to screen 100% of Salmonella isolates for resistance (currently, only 1-in-20 isolates are tested). Sequencing efforts will protect communities by rapidly identifying drug-resistant foodborne bacteria, like E. coli, Shigella, and Campylobacter, to stop and solve outbreaks and improve prevention. In addition, CDC is developing local and state health department epidemiological and laboratory capacity to more rapidly detect and effectively respond to antibiotic-resistant gonorrhea in high-risk communities. Gonorrhea is one of the most commonly reported infectious diseases in the United States and increasingly resistant to most antibiotics. In April and May 2016, through rapid identification and response, public health efforts stopped further spread of a gonorrhea cluster that showed high levels of resistance and decreased susceptibility to the primary drugs used for treatment.
• More labs identifying antibiotic resistance. CDC provided funding to health departments in July 2016 to help tackle antibiotic resistance and patient safety threats nationwide, including HAIs and “nightmare bacteria” carbapenem-resistant Enterobacteriaceae (CRE), through the Antibiotic Resistance Laboratory Network (ARLN). State public health laboratories in the ARLN can detect new forms of antibiotic resistance, like mcr-1, and report these findings to CDC to inform response and prevention activities. Additionally, all state public health labs will have enhanced CRE testing capabilities.
• Timely antibiotic resistance data. CDC released the Antibiotic Resistance Patient Safety Atlas web app in 2016 that provides indicators for the types of resistance most common in individual states and regions. It allows users to look up antibiotic resistance patterns in HAIs by state and region. This expands on the public access to antibiotic resistance data. In 2015, CDC introduced NARMS Now: Human Data, an interactive tool that shows how antibiotic resistance has changed over the past 20 years for four bacteria transmitted commonly through food. In 2016, for the first time, NARMS Annual Human Isolates Surveillance Report includes human WGS data of resistant Salmonella infections.
• Antibiotic resistance research. In 2016, CDC awarded funds to support applied research at five academic medical centers as part of a patient safety effort known as Prevention Epicenters Program. The new funding more than doubles previous awards and expands and extends the Prevention Epicenters program to 2020. CDC also awarded funds for new approaches to combat antibiotic resistance. Research will include how microorganisms naturally present in the human body (referred to as a person’s microbiome) can be used to predict and prevent infections caused by antibiotic-resistant organisms. This research will work to identify effective public health approaches that protect people, their microbiomes, and the effectiveness of antibiotics.
• Global efforts. Under the Global Health Security Agenda, CDC is engaging 17 countries to support and measure progress toward strengthening laboratories and to develop action plans to establish or strengthen laboratory surveillance networks. To fight drug-resistant tuberculosis (TB)—now the leading infectious disease killer worldwide—CDC is developing innovative strategies to find, cure, and prevent TB, including multidrug-resistant TB, and working with highest burden countries of origin for TB among foreign-born U.S. residents to strengthen surveillance and laboratory systems. CDC is also working with partners from the Transatlantic Taskforce for Antimicrobial Resistance and the World Health Organization to develop a portal for rapid global communication of antibiotic resistance findings requiring international attention.

CDC in the 21st Century

• On the cutting edge of health security – confronting global disease threats through advanced computing and lab analysis of huge amounts of data to quickly find solutions.
• Putting science into action – tracking disease and finding out what is making people sick and the most effective ways to prevent it.
• Helping medical care – bringing new knowledge to individual health care and community health to save more lives and reduce waste.
• Fighting diseases before they reach our borders – detecting and confronting new germs and diseases around the globe to increase our national security.
• Nurturing public health - building on our significant contribution to have strong, well-resourced public health leaders and capabilities at national, state and local levels to protect Americans from health threats.

Pledge to the American People

1. Be a diligent steward of the funds entrusted to our agency:

CDC accomplishes agency-wide fiscal accountability and oversight of appropriations, acquisitions, assistance, and financial management of government funds. This aids in CDC’s public health mission by ensuring appropriate fiscal stewardship of tax payer dollars.

https://www.cdc.gov/funding/index.html

2. Provide an environment for intellectual and personal growth and integrity:

CDC expects that employees know and follow the fourteen principles of ethical conduct for executive branch personnel. These principles help foster growth for both individual employee and agency wide progress to further public health science, and maintain the public’s trust.

https://www.cdc.gov/ethics/index.html

3. Base all public health decisions on the highest quality scientific data that is derived openly and objectively:

CDC ensures its science and research activities, as well as employees, comply with various federal laws, regulations, and policies in order to exercise the highest level of scientific integrity. To “enhance the quality, integrity of and access to CDC science,” is one of 4 pillars the Office of the Associate Director of Science at CDC considers a priority and responsibility.

https://www.cdc.gov/od/science/integrity/index.htm

4. Place the benefits to society above the benefits to our institution:

CDC employees are prohibited from participating in any manner that would pose a conflict of interest or appearance of bias. This helps ensure CDC achieves the highest quality of scientific research, and works to protect the nation’s health.

https://www.cdc.gov/about/business/business-sector/ethical-considerations.html

https://www.cdc.gov/ethics/resources/topics/conflicts.html

5. Treat all persons with dignity, honesty, and respect:

The Principles of the Ethical Practice of Public Health is intended principally for public and other institutions in the United States that have an explicit public health mission. It contains values and beliefs underlying the code, principles of the ethical practice of public health, and supplemental materials.

https://www.cdc.gov/od/science/integrity/phethics/

https://www.whitehouse.gov/the-press-office/memorandum-heads-executive-departments-and-agencies-3-9-09