Centers for Disease Control and Prevention

"Centers for Disease Control" redirects here. For the Centers for Disease Control in Taiwan, see Centers for Disease Control (Republic of China).
Centers for Disease Control and Prevention
Agency overview
Formed July 1, 1946
Preceding agencies Office of National Defense Malaria Control Activities (1942)
Office of Malaria Control in War Areas (1942–1946)
Communicable Disease Center (1946–1967)
National Communicable Disease Center (1967–1970)
Center for Disease Control (1970–1980)
Centers for Disease Control (1980–1992)
Jurisdiction Federal government of the United States
Headquarters DeKalb County, Georgia
Employees 15,000
Annual budget US$6.9 billion (2014 FY)
Agency executive Thomas R. Frieden, MD, MPH, Director, Centers for Disease Control and Prevention
Parent agency United States Department of Health and Human Services
Website cdc.gov

The Centers for Disease Control and Prevention is the leading national public health institute of the United States. The CDC is a federal agency under the Department of Health and Human Services and is headquartered in unincorporated DeKalb County, Georgia, a few miles northeast of the Atlanta city limits.[1][2][3]

Its main goal is to protect public health and safety through the control and prevention of disease, injury, and disability. 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. In addition, the CDC researches 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.[4]

History

CDC headquarters in Druid Hills, Georgia, as seen from Emory University
CDC′s Roybal campus in Atlanta, GA
Arlen Specter Headquarters and Emergency Operations Center
Tom Harkin Global Communications Center

The Communicable Diseases Center was founded July 1, 1946, as the successor to the World War II Malaria Control in War Areas program[5] of the Office of National Defense Malaria Control Activities.[6] Preceding its founding, organizations with global influence in malaria control were the Malaria Commission of the League of Nations and the Rockefeller Foundation.[7] The Rockefeller Foundation greatly supported malaria control,[7] sought to have the governments take over some of its efforts, and collaborated with the agency.[8]

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 (see infobox on top) 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[9] (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 Dr. Joseph Mountin, the CDC continued to advocate for public health issues and pushed to extend its responsibilities to many other communicable diseases. In 1947, 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 today. 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.[5]

The mission of 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.[10]

It became the National Communicable Disease Center (NCDC) effective July 1, 1967.[6] The organization was renamed the Center for Disease Control (CDC) on June 24, 1970, and Centers for Disease Control effective October 14, 1980.[6] 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.[11] CDC now operates under the Department of Health and Human Services umbrella.

Currently 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 to having sent several biological warfare agents to the Iraqi government from 1984 through 1989, including Botulinum toxin, West Nile virus, Yersinia pestis and Dengue fever virus.[12]

On April 21, 2005, the then-director of CDC, Dr. Julie Gerberding, formally announced the reorganization of CDC to "confront the challenges of 21st-century health threats".[13] The four Coordinating Centers—established under the G. W. Bush Administration and Gerberding—"diminished the influence of national centers under [their] umbrella" and were ordered cut under the Obama Administration and Frieden in 2009.[14]

The CDC's Biosafety Level 4 laboratories are among only about a dozen such facilities in the country,[15] as well as one of only two official repositories of smallpox in the world. The second smallpox store resides at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation. The CDC revealed in 2014 that it had discovered several misplaced smallpox samples and that lab workers had also potentially been infected with anthrax.[16]

Organization

The CDC is organized into "Centers, Institutes, and Offices" (CIOs) which allow it to be responsive and effective in its interface with public health concerns. Each organizational unit implements the agency's response in a particular area of expertise. Within "Offices" are Centers, Divisions, and Branches.

The CIOs are:

Budget and workforce

CDC’s FY2014 budget is $6.9 billion.[17][18] As of 2008, staff numbered approximately 15,000 (including 6,000 contractors and 840 Commissioned Corps officers) in 170 occupations. Eighty percent have earned bachelor's degrees or higher; almost half have advanced degrees (a master's degree or a doctorate such as a PhD, D.O., or M.D.).[19] CDC job titles include engineer, entomologist, epidemiologist, biologist, physician, veterinarian, behaviorial scientist, nurse, medical technologist, economist, public health advisor, health communicator, toxicologist, chemist, computer scientist, and statistician.[20]

In addition to its Atlanta headquarters, the CDC has other locations in the United States and Puerto Rico. Those locations include Anchorage; Cleveland; Cincinnati; Fort Collins; Hyattsville; Morgantown; Pittsburgh; Research Triangle Park; San Juan, Puerto Rico; Spokane, Washington; Detroit; and Washington, D.C. The CDC also conducts the Behavioral Risk Factor Surveillance System, the world’s largest, on-going telephone health survey system.[21]

The CDC offers grants that help many organizations each year bring health, safety and awareness to surrounding communities throughout the entire United States. As a government-run department, the Centers for Disease Control and Prevention awards over 85 percent of its annual budget through these grants to accomplish its ultimate goal of disease control and quality health for all.[22]

The CDC operates the Public Health Associate Program (PHAP), a two-year paid fellowship for recent college graduates to work in public health agencies all over the United States. PHAP was founded in 2007 and currently has 159 associates in 34 states.[23]

Directors

David Sencer points to a depiction of Triatomine sp., which transmits Chagas disease.

The President of the United States appoints the director of the CDC and the appointment does not require Senate confirmation. The director serves at the pleasure of the President and may be fired at any time.[24][25] Sixteen directors have served the CDC or its predecessor agencies.[26][27]

Foundation

The CDC Foundation[29] operates independently from CDC as a private, nonprofit 501(c)(3) organization incorporated in the State of Georgia. The creation of the Foundation was authorized by section 399F of the Public Health Service Act to support the mission of CDC in partnership with the private sector, including organizations, foundations, businesses, educational groups, and individuals.

Data and survey systems

Publications

Diseases

Donald Henderson as part of the CDC's smallpox eradication team in 1966.

Influenza

The CDC has launched campaigns targeting the transmission of influenza, including the H1N1 swine flu. The CDC has launched websites including [flu.gov] to educate people in proper hygiene.[40]

Other infectious diseases

The CDC's website (see below) has information on other infectious diseases, including smallpox, measles, and others. The CDC runs a program that protects the public from rare and dangerous substances such as anthrax and the Ebola virus. The program, called the Select Agents Program, calls for inspections of labs in the U.S. that work with dangerous pathogens.[41]

During the 2014 Ebola outbreak in West Africa, the CDC helped coordinate the return of two infected American aid workers for treatment at Emory University Hospital, the home of a special unit to handle highly infectious diseases.[42]

As a response to 2014 Ebola outbreak, the U.S. House of Representatives proposed and passed a Continuing Appropriations Resolution to allocate up to $30,000,000 towards CDCP's efforts to fight the virus.[43]

Non-infectious disease

The CDC also works on non-infectious diseases, including obesity.

Investigations by the DHHS Office of Inspector General (OIG)

On June 15, 2011, the OIG published a report critical of the CDC's failure to oversee recipients' use of President's Emergency Plan for AIDS Relief (PEPFAR) funds.[44] The report read in part:

Our review found that CDC did not always monitor recipients' use of President's Emergency Plan for AIDS Relief (PEPFAR) funds in accordance with departmental and other Federal requirements. CDC implements PEPFAR, working with ministries of health and other public health partners to combat HIV/AIDS by strengthening health systems and building sustainable HIV/AIDS programs in more than 75 countries in Africa, Asia, Central and South America, and the Caribbean. HHS receives PEPFAR funds from the Department of State through a memorandum of agreement.

There was evidence that the CDC performed some monitoring of recipients' use of PEPFAR funds. However, most of the award files did not include all required documents or evidence to demonstrate that CDC performed required monitoring on all cooperative agreements. Of the 30 cooperative agreements in our sample, the award file for only 1 agreement contained all required documents. The remaining 29 award files were incomplete. In addition, 14 of 21 files were missing audit reports. (A report was not yet due for 9 of the 30 cooperative agreements.) The lack of required documentation demonstrates that CDC has not exercised proper stewardship over Federal PEPFAR funds because it did not consistently follow departmental and other Federal requirements in monitoring PEPFAR recipients.

“
”

On June 5, 2012, the OIG published a report identifying vulnerabilities in vaccine management in the CDC's domestic 'Vaccines for Children' (VFC) program.[45] The report read in part:

Although the majority of storage temperatures we independently measured during a 2-week period were within the required ranges, VFC vaccines stored by 76 percent of the 45 selected providers were exposed to inappropriate temperatures for at least 5 cumulative hours during that period. Exposure to inappropriate temperatures can reduce vaccine potency and efficacy, increasing the risk that children are not provided with maximum protection against preventable diseases. Thirteen providers stored expired vaccines together with non-expired vaccines, increasing the risk of mistakenly administering the expired vaccine. Finally, the selected providers generally did not meet vaccine management requirements or maintain required documentation. Similarly, none of the five selected grantees met all VFC program oversight requirements, and grantee site visits were not effective in ensuring that providers met vaccine management requirements over time.

“
”

On the November 19, 2012, the OIG published a report critical of the CDC Namibia Office's failure to properly monitor recipients' use of PEPFAR funds.[46] The report read in part:

CDC's office in Windhoek, Namibia (CDC Namibia), is responsible for PEPFAR funds awarded to government agencies and for-profit and non-profit organizations (recipients) in Namibia. Our audit found that CDC Namibia did not always monitor recipients' use of PEPFAR funds in accordance with HHS and other Federal requirements. There was evidence that CDC Namibia performed some monitoring of recipients' use of PEPFAR funds. However, most of the recipient cooperative agreement files did not include required documents or evidence that CDC Namibia had monitored all cooperative agreements. CDC Namibia did not consistently monitor the cooperative agreements in accordance with HHS and other Federal requirements because it did not have written policies and procedures for the monitoring process. As a result, CDC Namibia did not have assurance that PEPFAR funds were used as intended by law. We recommended that CDC Namibia implement standard operating procedures for monitoring recipients' use of PEPFAR funds. CDC concurred with our recommendation.

“
”

Controversies

For 15 years, the CDC had direct oversight over the "Tuskegee Study of Untreated Syphilis in the Negro Male". In the study, which lasted from 1932 to 1972, a group of African American men (nearly 400 of whom had syphilis) were studied to learn more about the disease. Notably, the disease was left untreated in the research subjects and they never gave their informed consent to serve as research subjects. The Tuskegee Study was initiated in 1932 by the Public Health Service. The the CDC took over the study in 1957.

In the wake of the 2014 Ebola crisis in the United States, columnist Michelle Malkin drew attention to CDC priorities and spending patterns on politically devised non-disease control-related priorities, including motorcycle helmet laws, video games/media imagery studies, and playground injury centers.[47]

CDC zombie apocalypse outreach campaign

On May 16, 2011, the Centers for Disease Control and Prevention's blog published an article instructing the public on what to do to prepare for a zombie invasion. While the article did not claim that such a scenario was possible, it did use the popular culture appeal as a means of urging citizens to prepare for all potential hazards, such as earthquakes, tornadoes, and floods.[48]

According to David Daigle, the Associate Director for Communications, Public Health Preparedness and Response, the idea arose when his team was discussing their upcoming hurricane information campaign and Daigle mused that "we say pretty much the same things every year, in the same way, and I just wonder how many people are paying attention." A social media employee mentioned that the subject of zombies had come up a lot on Twitter when she had been tweeting about the Fukushima Daiichi nuclear disaster and radiation. The team realized that a campaign like this would most likely reach a different audience from the one that normally pays attention to hurricane preparedness warnings and went to work on the zombie campaign, launching it right before hurricane season began. "The whole idea was, if you're prepared for a zombie apocalypse, you're prepared for pretty much anything," said Daigle.[49]

Once the blog article became popular, the CDC announced an open contest for YouTube submissions of the most creative and effective videos covering preparedness for a zombie apocalypse (or apocalypse of any kind), to be judged by the "CDC Zombie Task Force". Submissions were open until October 11, 2011.[50] They also released a zombie themed graphic novella available on their website.[51] Zombie-themed educational materials for teachers are available on the site.[52]

See also

Wikimedia Commons has media related to Centers for Disease Control and Prevention.

For similar agencies elsewhere, see the list of national public health agencies.

References

  1. ↑ CDC Home Page, cdc.gov; retrieved November 19, 2008.
  2. ↑ "Groundbreaking held for new CDC virus research labs", Atlanta Journal-Constitution, December 3, 1985, p. A21; retrieved February 5, 2011. "The new facility will sit behind and be connected to CDC's red-brick complex of buildings on Clifton Road in DeKalb County[...]"
  3. ↑ "Druid Hills CDP, GA", United States Census Bureau; retrieved May 5, 2009.
  4. ↑ cdc.gov
  5. ↑ 5.0 5.1 Parascandola J (November–December 1996). "From MCWA to CDC—origins of the Centers for Disease Control and Prevention". Public Health Reports 111 (6): 549–51. PMC 1381908. PMID 8955706.
  6. ↑ 6.0 6.1 6.2 "Records of the Centers for Disease Control and Prevention (Record Group 442) 1921–2004". Guide to Federal Records. United States: National Archives and Records Administration. November 9, 2010. Archived from the original on November 18, 2010. Retrieved 2009-10-04.
  7. ↑ 7.0 7.1 Nájera JA (June 2001). "Malaria control: achievements, problems and strategies". Parassitologia 43 (1–2): 1–89. PMID 11921521.
  8. ↑ Stapleton DH (2004). "Lessons of history? Anti-malaria strategies of the International Health Board and the Rockefeller Foundation from the 1920s to the era of DDT". Public Health Rep 119 (2): 206–15. PMC 1497608. PMID 15192908.
  9. ↑ Division of Parasitic Diseases (February 8, 2010). "Malaria Control in War Areas (1942–1945)". The History of Malaria, an Ancient Disease (2004). Atlanta, Georgia: Centers for Disease Control and Prevention. Retrieved 2011-03-21.
  10. ↑ Beth E. Meyerson, Fred A. Martich, Gerald P. Naehr (2008). Ready to Go: The History and Contributions of U.S. Public Health Advisors. Research Triangle Park: American Social Health Association.
  11. ↑ CDC (1992). "CDC: the nation's prevention agency". MMWR Morb Mortal Wkly Rep 41 (44): 833. PMID 1331740. Archived from the original on November 18, 2010.
  12. ↑ "The eleventh plague: the politics of biological and chemical warfare" (pp. 84-86) by Leonard A. Cole (1993)
  13. ↑ "CDC Office of Director, The Futures Initiative". CDC—National Center for Disease Control and Prevention. Retrieved 2008-12-28.
  14. ↑ Koenig, Robert. "New Chief Orders CDC to Cut Management Layers". Blogs.sciencemag.org. Retrieved 2012-04-16.
  15. ↑ "CDC Special Pathogens Branch". Retrieved 2010-01-19.
  16. ↑ "CDC Smallpox and Anthrax Mishaps Signal Other Potential Dangers". Retrieved October 17, 2014.
  17. ↑ "CDC wins in budget deal". Atlanta Business Chronicle.
  18. ↑ "Budget Request Summary—Fiscal Year 2015" (PDF). Centers for Disease Control and Prevention.
  19. ↑ Office of the Associate Director for Communication (May 19, 2010). "State of CDC: Budget and Workforce" (XHTML). CDC Impact Story Topics. Centers for Disease Control and Prevention. Retrieved 2011-03-21. For more data on 2008, click on the "2008" link.
  20. ↑ "Top Jobs at the CDC". Employment Information Homepage. CDC. April 1, 2008. Retrieved 2011-03-21.
  21. ↑ "Behavioral Risk Factor Surveillance System". CDC: National Center for Chronic Disease Prevention and Health Promotion. Retrieved 2006-08-05.
  22. ↑ "CDC Grants at LoveToKnow Charity". Retrieved 2010-01-11.
  23. ↑ Public Health Associate Program website, Cdc.gov; retrieved 2014-04-12.
  24. ↑ 24.0 24.1 Wilgoren, Debbi and Shear, Michael D. "Obama Chooses NYC Health Chief to Head CDC." Washington Post. May 16, 2009.
  25. ↑ Etheridge, Elizabeth W. Sentinel for Health: A History of the Centers for Disease Control. Berkeley, Calif.: University of California Press, 1992; ISBN 978-0-520-07107-0; Patel, Kant; Rushefsky, Mark E.; and McFarlane, Deborah R. The Politics of Public Health in the United States. M.E. Sharpe, 2005; ISBN 978-0-7656-1135-2.
  26. ↑ "Past CDC Directors/Administrators". Office of Enterprise Communication. Centers for Disease Control and Prevention (U.S. Department of Health and Human Services). February 19, 2009. Retrieved 2009-05-19.
  27. ↑ Records of the Centers for Disease Control and Prevention Administrative History; retrieved 2009-10-04.
  28. ↑ "National Public Health Institute, NPHI Advocacy". IANPHI. Retrieved 2012-04-16.
  29. ↑ "CDCfoundation.org". CDCfoundation.org. Retrieved 2012-04-16.
  30. ↑ "CDC Data and Statistics". CDC – National Center for Chronic Disease Prevention and Health Promotion. Retrieved 2006-08-10.
  31. ↑ "Behavioral Risk Factor Surveillance System". CDC – National Center for Chronic Disease Prevention and Health Promotion. Retrieved 2006-08-10.
  32. ↑ "NCHS – Mortality Data – About the Mortality Medical Data System". CDC – National Center for Health Statistics. Retrieved 2007-01-09.
  33. ↑ "CDC – Data and Statistics – Reproductive Health". Cdc.gov. April 4, 2012. Retrieved 2012-04-16.
  34. ↑ "CDC – Publications". CDC – National Center for Disease Control and Prevention. Retrieved 2012-10-10.
  35. ↑ "State of CDC Report". CDC – National Center for Disease Control and Prevention. Retrieved 2012-10-10.
  36. ↑ "Programs in Brief: Home Page". CDC – National Center for Disease Control and Prevention. Archived from the original on July 18, 2006. Retrieved 2006-08-10.
  37. ↑ "Morbidity and Mortality Weekly Report". CDC – National Center for Disease Control and Prevention. Retrieved 2012-10-10.
  38. ↑ "Emerging Infectious Diseases". CDC – National Center for Disease Control and Prevention. Retrieved 2012-10-10.
  39. ↑ "CDC/National Center for Health Statistics". Retrieved October 14, 2014.
  40. ↑ CDC Health Topics A to Z, cdc.gov; accessed April 26, 2015.
  41. ↑ Cohen, Bryan. "CDC’s Select Agents Program protects against bioterror threats". BioPrepWatch, February 10, 2014; accessed October 17, 2014.
  42. ↑ Achenbach, Joel; Dennis, Brady; Hogan, Caelainn. "American doctor infected with Ebola returns to U.S.". www.washingtonpost.com. The Washington Post. Retrieved August 2, 2014.
  43. ↑ "Continuing Appropriations Resolution, 2015" (PDF). congress.gov. Retrieved September 17, 2014.
  44. ↑ "Review of the Centers for Disease Control and Prevention’s Oversight of the President's Emergency Plan for AIDS Relief Funds for Fiscal Years 2007 Through 2009 (A-04-10-04006)" (PDF). Retrieved 2011-06-25.
  45. ↑ "Vaccines for Children Program: Vulnerabilities in Vaccine Management (Report OEI-04-10-00430)" (PDF). June 2012. Retrieved 2012-06-06.
  46. ↑ "The Centers for Disease Control and Prevention's Namibia Office Did Not Always Properly Monitor Recipients' Use of the President's Emergency Plan for AIDS Relief Funds (A-04-12-04020)" (PDF). November 2012. Retrieved 2012-12-07.
  47. ↑ Malkin, Michelle. "Centers for anything but disease control", New York Post, October 17, 2014, p. 29.
  48. ↑ Khan, Ali S. (2011-05-16). "CDC Zombie Warning". "Preparedness 101: Zombie Apocalypse". Retrieved 2014-03-08.
  49. ↑ "Skepticality Podcast". Centers for Zombie Control and Prevention. 2011-10-25. Retrieved 2014-03-08.
  50. ↑ "Are You Prepared? Video Contest". Prepare.challenge.gov. Retrieved 2012-04-16.
  51. ↑ "Preparedness 101: Zombie Pandemic". 2012-07-16. Retrieved 2014-03-08.
  52. ↑ "Zombie Preparedness". Retrieved 2014-03-08.

External links

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