The Competitive Enterprise Institute (CEI) and the Paragon Health Institute published a new paper today by CEI senior fellow and director of Paragon’s Public Health and American Well-Being Initiative Joel Zinberg and Paragon senior policy analyst Drew Keyes. The report, Unauthorized and Unprepared: Refocusing the CDC after COVID-19, examines the Centers for Disease Control and Prevention’s (CDC) failures during the pandemic – acknowledged by the agency – and suggests how the CDC can be reformed and refocused.
The authors found the basic problem was CDC mission creep, abetted by the lack of congressional authorization for the agency. Because the CDC has never been fully authorized by Congress, it lacks goals, circumscribed powers, and effective oversight. This led to a rapid and haphazard expansion of its responsibilities as the CDC became a large, diffuse agency with priorities that are far afield from its core mission of controlling and preventing communicable disease outbreaks.
CDC is now a collection of centers and programs that are disconnected from each other and from state and local authorities, and duplicative of programs in other agencies and departments. These redundancies are unnecessary, costly, and divert the CDC from its primary purpose. Just a small fraction of CDC resources is devoted to communicable disease threats. The lack of focus left the agency unprepared for the pandemic and distracted it from an effective response.
The authors write:
The CDC’s failures during the pandemic undermined public trust. Americans deserve a more focused and less political public health agency. Unless the CDC is reformed and refocused on its core mission, it will be unprepared to act effectively in future pandemics.
We cannot rely on CDC to reform itself—bureaucracies rarely do. Congress’ job is to define CDC’s role. Instead of blindly increasing funding, Congress should comprehensively authorize the CDC for the first time and reaffirm the agency’s core mission.
Congress must delineate agency’s responsibilities and cut back on areas where the CDC does not have expertise and duplicates other authorized agencies’ programs. Congress should remove off-mission priorities—such as broad prevention initiatives, social determinants of health, environmental issues, and violence prevention—to agencies where they can be, or already are better addressed. These reforms would help restore public trust and make the CDC more effective and better prepared to combat the next pandemic.