CDC Moving Forward

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Key Takeaways
  • There is a strategic imperative to modernize CDC so that it consistently delivers public health information and guidance to Americans in real time – a mission recognized by the talented people who work here and by public health experts around the globe.
  • Throughout her tenure as director, and over the last few months in particular, Dr. Walensky has evaluated CDC operations; she listened – to voices from within CDC, to our partners and other interested parties, and to external reviewers.
  • The director announced a series of changes that will prioritize public health action to help equitably protect and promote the health of the American people.
  • The optimizations are designed to not only change how CDC operates but also its culture, orienting it toward timely action – ensuring CDC’s science reaches the public in an understandable, accessible, and implementable manner as quickly as possible.
CDC Review
Looking Forward
  • The action steps outlined by the director are intended to not only inform what we can do during a pandemic, but also during normal operations, to ensure our science and programs reach the public in a timely and effective manner.
  • There is a lot of work ahead to better position CDC for success:
    • First, we must institutionalize new internal systems, processes, and policies to improve our accountability, collaboration, communication, and timeliness within CDC and with our customers, at all levels of the organization.
    • Second, we must take our concrete lessons learned from COVID-19 to improve how we deliver our science, guidance, and programs to the American people.
    • Next, we will reorganize to facilitate a more cohesive and customer centric structure.
    • Finally, we will finalize a list of programs, flexibilities, and authorities that will enable us to do our work faster and more effectively in the future.
Background

We launched this effort in April to:

  • Position the agency to better support the future of public health.
  • Strengthen systems and processes to equitably deliver CDC’s science and program activities to the American people.
  • Conduct interviews and collect data to determine how CDC should be structured to focus on the agency’s core capabilities that apply to each of our CIOs – diverse public health workforce, data modernization, laboratory capacity, rapid response to disease outbreaks, and preparedness within the US and around the world – and break down silos.
  • Create new internal processes, systems, and governance to empower leaders, align incentives, and hold us accountable.
Findings
  • At the core of everything we do as an agency is our institutional culture – from how we interact with partners, to how we implement programs, to how we publish our science.
  • The need for change came through loud and clear.
  • This means improving our accountability, collaboration, communication, and timeliness within CDC and with our customers, at all levels of the organization.
Recommendations
  • Over the coming months, we will implement changes across the agency that will set the foundation for large-scale cultural and operational changes to improve organizational accountability:
    • We will work together to stand up new internal systems, processes, and policies to enhance bi-directional communication and accountability.
    • Our core capabilities and agency-wide initiatives will have clear outcomes and timeframes for deliverables and bi-directional engagement.
    • We will implement new governance structures, to ensure accountability, closely tied to funding decisions.
  • Concurrently, we will employ lessons learned from COVID-19 to improve how we deliver our science and programs. Our objectives are to:
    • Share Scientific Findings and Data Faster
    • Translate Science into Practical, Easy to Understand Policy
    • Prioritize Public Health Communications
    • Promote Results-Based Partnerships
    • Develop a Workforce Prepared for Future Emergencies
  • We are going to move forward with some organizational changes. However, that alone is not enough. We will modernize CDC to better prepare us for future public health challenges to include the next pandemic.
  • Finally, the lessons of COVID-19 uncovered the need for levers that do not exist today at CDC, including budget flexibility and new authorities that will allow us to be more nimble and work faster, such as:
    • Public health and regulatory authorities (e.g., mandatory data reporting, paperwork reduction action exemptions, etc.)
    • Human resource authorities (e.g., hazard pay, overtime pay, direct hire authority, hiring authority exemption, etc.)
    • Other operational authorities (e.g., other transaction authority, personal services contracting, etc.)
Next Steps

To move the agency forward we will immediately begin our first steps by:

  • Appointing a seasoned executive to lead a team that will help implement the vision.
  • Elevating the Science and Laboratory Sciences to report to the director, improving accountability for delivering timely information.
  • Starting a process to make structural changes to incentivize public health action, implementation, and impact at all levels of the organization.
  • Creating a new executive council – reporting to the Director – that will determine agency priorities, track progress, and align budget decisions, with a bias toward public health impact.
  • Creating a one-stop shop for external partners to navigate the agency.
  • Creating a new equity office that will promote this focus across all of the work CDC does, as well as how the agency operates; a CDC that reflects the diversity of America will be better positioned to respond to outbreaks – from science to communications.