Executive Summary

On April 20, 2021, CDC launched an agency-wide health equity science and intervention strategy to holistically reimagine how the agency approaches health equity. CDC commits to: Cultivate comprehensive health equity science, Optimize interventions, Reinforce and expand robust partnerships, and Enhance capacity and workforce engagement (also known as CORE commitments). CDC Director, Dr. Rochelle Walensky, states, “As America’s public health agency and as a leader of public health globally, CDC is reaffirming our commitment to health for all.”

Five pillars guide CDC’s global public health work across the agency: scientific expertise, diverse partnerships, innovation, sustainability, and health equity. CDC works to eliminate health disparities and achieve optimum health through all these pillars, and more specifically by addressing health equity to reach those in greatest need through global programs, research, tools and resources, and leadership.

Under CORE, the agency-wide health equity vision is that CDC is a trusted and proven public health leader in advancing health equity. The aim, according to Dr. Leandris Liburd, Director of CDC’s Office of Minority Health and Health Equity, is “to integrate health equity into the very fabric of all we do as the nation’s leading health agency.”

The CORE long-term goals commit CDC to ensure that:

  1. Health equity is an integral part of CDC’s scientific portfolio
  2. CDC programs and interventions embed health equity into their design, implementation, and evaluation
  3. CDC uses scientific and data-driven intervention strategies that address environmental, place-based, occupational, policy and systemic factors that impact health outcomes and shape equitable opportunities for health
  4. CDC scientific and intervention work uses partnerships and innovative data and analytic approaches to address multi-level drivers of health disparities

Framework and Guiding Principles

The Four United Nations Essential Components for Achieving the Right to the Highest Attainable Level of Health framework, endorsed by WHO, are foundational to CDC’s global public health guiding principles, global health equity vision and goals.

United Nations Core Components to Achieving the Highest Attainable Level of Health
  • Availability: sufficient quantity of functioning Public Health facilities, goods, services, and programs
  • Accessibility: non-discrimination, physically accessible, affordable, access to information and programs
  • Acceptability: respectful of medical ethics, culturally appropriate, sensitive to gender issues
  • Quality: scientific and medically appropriate, good quality public health services
Guiding Principles for Implementing Health Equity into CDC’s Global Work
  • Prioritize the needs of the most disadvantaged or disproportionately affected
  • Engage affected populations and communities
  • Collaborate with external partners, including non- traditional, and local partners
  • Confirm that programs uphold principles of human rights
  • Implement good and ethical public health practice
  • Cultivate ethical and knowledgeable staff

CDC Global Health Equity

Vision: Everyone can achieve the highest attainable level of health, and no one is disadvantaged from achieving this potential because of social position or any other socially, economically, demographically, or geographically defined circumstances or physical condition.

Cross-cutting Goal 1:
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By 2027, building on CDC’s core strengths in scientific leadership, innovation, surveillance, laboratory, and using data to drive impact, CDC will assess and strengthen our capacity, infrastructure, policies, and partnerships to consistently and deliberatively apply global health equity principles and approaches to our global health science, interventions, programs, policy development, and communication

Cross-cutting Goal 2:
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By 2027, build the evidence-base to advance health equity in our global health science and interventions

Cross-cutting Goal 3:
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By 2027, implement standard health equity measures that will be seamlessly integrated into CDC global data collection efforts (e.g., surveys, surveillance, routine program, supply chain, laboratory) and used to reach epidemic and accelerated disease control, and disease eradication and elimination among known and unknown groups who are marginalized

Program-specific goals

Parasitic Diseases and Malaria

Goal 1:
Identify the primary social determinants of health that increase the risk for parasitic diseases in underserved US communities (by 2023), and develop/implement a strategy to increase awareness, promote access to disease prevention services, and increase use of prevention practices (by 2026) with a focus on soil transmitted helminths and malaria.

Goal 2:
By end of 2025, increase access to a package of community care* by 30% in remote areas currently underserved by peripheral health facilities in three high-burden malaria countries where US President’s Malaria Initiative operates, as measured by a 30% increase in all cause consults for illness treated by CHWs, to address health services disparities, particularly in rural areas.

*The package of community care includes integrated community case management (iCCM) of pneumonia, diarrhea, and malaria for children under 5 and access to diagnosis and treatment for acute febrile illness for all ages.

Global Health Protection

Goal 1:
By 2025, CDC to work with the broader community of National Public Health Institutes (NPHI) to support defining and accelerating progress towards health equity goals and developing and adopting health equity strategies in support of the global health security goal to enhance essential public health workforce and functions.

Goal 2:
By 2026, CDC and partners will address disparities in access to preventive health care by promoting primary health care principles through the global health security framework to integrate infectious diseases and other health threats prevention program planning and delivery, thereby reducing their synergistic impact during public health threats and improving our approach to pandemic preparedness.

Global HIV & TB

Goal 1:
Affirm and advance the role of health equity and an equitable, diverse, and inclusive workforce as core principles for the work of CDC through continuous improvement and monitoring by September 30, 2023.

Goal 2:
Advance the reduction of stigma and discrimination through the promotion of civil and human rights to improve the health outcomes of persons at risk of, or living with, HIV and/or TB infection in countries where CDC works by September 30, 2025.

Global Immunization

Goal 1:
By December 31, 2026, in all CDC priority countries, underserved populations with immunity gaps* are identified and reached with vaccination services to achieve measurable reductions in mortality and morbidity from targeted VPDs.

*Underserved populations with immunity gaps who have disproportionately high risk for vaccine-preventable diseases (e.g., zero-dose children, populations affected by conflict, disaster and humanitarian crises, nomadic populations, populations with gender-related barriers to immunization, populations without access to recommended vaccines).