Centers For Disease Control

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 Atlanta, Georgia
Employees 15,000
Annual budget US$11.3 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

The Centers for Disease Control and Prevention (CDC) is the 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 Atlanta, unincorporated DeKalb County, Georgia, in Greater Atlanta.[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.

History

The Communicable Diseases Center was founded July 1, 1946 as the successor to the World War II Malaria Control in War Areas program[4] of the Office of National Defense Malaria Control Activities.[5] Preceding its founding, organizations with global influence in malaria control were the Malaria Commission of the League of Nations and the Rockefeller Foundation.[6] The Rockefeller Foundation greatly supported malaria control,[6] sought to have the governments take over some of its efforts, and collaborated with the agency.[7]



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 right) 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[8] (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 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.[4]

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.[9]

It became the National Communicable Disease Center (NCDC) effective July 1, 1967.[5] The organization was renamed the Center for Disease Control (CDC) on June 24, 1970, and Centers for Disease Control effective October 14, 1980.[5] 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.[10] 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.[11]

The CDC has one of the few Biosafety Level 4 laboratories in the country,[12] 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.

Budget and workforce

CDC’s FY2008 budget was $9.2 billion. 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.).[13] CDC job titles also include engineer, entomologist, epidemiologist, biologist, physician, veterinarian, behaviorial scientist, nurse, medical technologist, economist, Public Health Advisor, health communicator, toxicologist, chemist, computer scientist, and statistician.[14]

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.[15]

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.[16]

The CDC also 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.[17]

Directors

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.[18][19] Sixteen directors have served CDC or its predecessor agencies.[20][21]

  • Louis L. Williams, Jr., MD (1942–1943)
  • Mark D. Hollis, ScD (1944–1946)
  • Raymond A. Vonderlehr, MD (1947–1951)
  • Justin M. Andrews, ScD (1952–1953)
  • Theodore J. Bauer, MD (1953–1956)
  • Robert J. Anderson, MD, MPH (1956–1960)
  • Clarence A. Smith, MD, MPH (1960–1962)
  • James L. Goddard, MD, MPH (1962–1966)
  • David J. Sencer, MD, MPH (1966–1977)
  • William H. Foege, MD, MPH (1977–1983)
  • James O. Mason, MD, MPH (1983–1989)
  • William L. Roper, MD, MPH (1990–1993)
  • David Satcher, MD, PhD (1993–1998)
  • Jeffrey P. Koplan, MD, MPH (1998–2002)[22]
  • Julie Gerberding, MD, MPH (2002–2008)
  • Thomas R. Frieden, MD, MPH (2009–present)[18]

Organizational restructuring

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".[23] 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.[24]

Foundation

The CDC Foundation[25] 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 with which the CDC is involved

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.

Other infectious diseases

The CDC's website (see below) has information on other infectious diseases, including smallpox, measles, and others.

Non-infectious disease

The CDC also combats non-infectious diseases, including obesity.

Investigations by the Department of Health and Human Services Office of Inspector General (OIG)

On the 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.[35] 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 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.[36] 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.[37] 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.

CDC zombie apocalypse video contest

Main article: Preparedness 101: Zombie Apocalypse

On May 18, 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 having individuals prepare for all potential hazards, such as earthquakes, tornadoes, and floods.[38] The recent proliferation of Zombie media provided a medium to contact citizens usually unaccustomed to dealing with the CDC.

Once the 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.[39]

See also

Notes and references

External links

  • The CDC Homepage
  • CDC Online Newsroom
  • CDC Health Topics A to Z
  • CDC Public Health Image Library
  • CDC Global Communications Center
  • CDC Emerging Infectious Diseases Laboratory – Atlanta, Georgia
  • RSS Feed
  • Proposed and finalized federal regulations from the Centers for Disease Control and Prevention

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Coordinates: 33°47′56″N 84°19′32″W / 33.798817°N 84.325598°W / 33.798817; -84.325598

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