Purging the CDC Could Be a Fatal Mistake

4 months ago 9

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(Bloomberg Opinion) -- Health Secretary Robert F. Kennedy Jr. is rapidly destroying our nation’s public health infrastructure.

The abrupt dismissal of the Centers for Disease Control and Prevention (CDC) director, combined with the exodus of several senior officials marks a deeply troubling escalation. These developments make crystal clear the extent to which Kennedy is willing to impose his anti-vaccine and anti-science ideology on the agencies tasked with protecting the health and well-being of Americans.

What does a world without a fully functional CDC look like? It could mean unreliable data on disease outbreaks — whether that’s a broad, real-time view of flu cases this winter or the ability to track and respond to emerging measles clusters. It might result in delays delivering treatments and vaccines to those who need them, or in slower efforts to identify the source of a foodborne illness. A local health department investigating a Legionnaire’s disease outbreak might not get the support it needs from CDC experts.

When the agency’s experienced leaders “are all gone, it means that in effect the system is not stable,” says Nirav Shah, who until March was the principal deputy director of the CDC. “When people call the CDC, who is picking up the phone?”

The drama began with a Washington Post report — later confirmed by the official Department of Health and Human Services’ X account – announcing that CDC Director Susan Monarez had been ousted. Within hours, news broke that several of the agency’s senior leaders, including the chief medical officer and three division directors, had resigned. Shortly after, a reversal emerged: Two attorneys representing Monarez stated that she had neither resigned nor been fired — and that she intended to stay in her post. The chaotic day culminated with Kush Desai, a spokesperson for President Donald Trump, telling the New York Times that Monarez had been fired.

Regardless of the outcome, Monarez demonstrated real integrity — especially for a leader just weeks into the role. And they were nothing if not eventful weeks. She walked into an agency already beleaguered from severe staffing and budget cuts that had drained morale and left critical operational gaps. Then came Kennedy’s disturbing interference with vaccine policy, beginning with his decision to fire all of the agency’s vaccine advisers. Less than two weeks after Monarez was sworn in, a gunman — angry over Covid vaccines — opened fire outside the CDC’s Atlanta headquarters, spraying hundreds of bullets. It was an attack on a federal institution that Trump never publicly acknowledged.

The tipping point this week appeared to be intensifying pressure from Kennedy to implement changes to the nation’s vaccine policy that contradicted scientific evidence. “When CDC director Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving a political agenda. For that, she has been targeted,” her lawyers said.

Kennedy, a notorious peddler of vaccine misinformation, has used his position to shape policies that will make it harder for millions of Americans to access vaccines. This week, that effort included limiting eligibility for Covid shots.

Two of the agency leaders who resigned cited the increasingly untenable environment at the CDC — pointing to political biases and censorship of science. Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases, specifically cited the recent decision to change Covid immunization schedules to exclude young children and pregnant women. He said the shift was made by HHS leadership without consulting CDC experts and without disclosing the data supporting the change. “I have never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people,” he said.

It's laudable that these CDC leaders stood by their principles. But their departures heighten anxiety that with each passing day, the agency is becoming weaker and less able to protect Americans, including from the HHS secretary’s meddling.

Every one of us depends on a complex, carefully coordinated public health ecosystem that monitors a wide range of threats at both the state and federal levels. Disrupt a single part of that system and the entire network feels the impact, one former CDC official told me. Now imagine punching holes across the entire framework.

Even before these latest developments, cracks in the nation’s public health infrastructure were already beginning to show. As KFF reported this week, when public health officials in Texas were grappling with a growing cluster of measles cases, their early calls to the CDC went unanswered. And when Milwaukee’s public health department asked the agency for help with an investigation into lead exposure in public schools, they were turned away.

Our national security is at risk as the country becomes less vigilant in preventing outbreaks — both at home and abroad. Shah recalled that when he visited other countries on behalf of the CDC, his usual message to health ministers was: “If something starts to happen from a public health perspective — I don’t care what it is — the CDC is your first phone call.” And many did call, knowing the CDC would step in to help. But now, if the phone rings and no one answers, that health minister might turn elsewhere — perhaps even to one of America’s adversaries — and the US will lose its advantage in staying ahead of a potential outbreak.

Of course, here at home, the constant threat to vaccine access grows more serious as Kennedy exerts increasing control over the CDC. Many public health experts worry, for example, that his ongoing investigation into the supposed “cause” of autism could ultimately lead to restrictions on routine childhood vaccinations — despite overwhelming scientific evidence to the contrary.

City and state public health departments will, of course, continue to operate and may be able to fill some of the gaps. But without the coordination, guidance and resources of the CDC, their job becomes much harder. Meanwhile, medical associations and other organizations are stepping up to establish and defend evidence-based vaccine policies.

But a patchwork of local and independent efforts — while laudable — will undoubtedly increase confusion about whom to trust. And it will never carry the authority of a unified national voice like the CDC. What’s truly terrifying is how dangerous that loss that could be to public health — and how long it may take to rebuild what Kennedy is tearing down.