The Communicable Disease Center was established by Congress in July of 1946 for the purpose of preventing malaria from spreading in the United States. By 1951 malaria was eradicated in the whole country. The name of the agency was changed to the Center for Disease Control (CDC) in 1981, and its mission, the study and control of infectious disease, had ballooned to include the research in non-infectious diseases. For instance, the epidemiology of lead poisoning and drug overdoses.
The CDC has made seminal contributions to public health efforts to control and treat important diseases. These include, but are not limited to, tuberculosis, tetanus, measles, polio, smallpox, cholera, rabies, sexually transmitted diseases, Lyme Disease, medical conditions born of tobacco use, HIV/Aids, alcoholism, Covid and countless others. Its reach is world-wide, with the CDC playing critical roles, for instance, in foreign countries to help contain the Ebola virus.
Over the years, the CDC has taken on initiatives and programs that dwarf its beginnings. It provides services to state public health departments and health institutions of foreign countries, including teams to help in outbreaks of disease, especially cryptic ones. It has trained thousands of epidemiologists (specialists in the identification and tracking of disease vectors) and other public health personnel.
Criticism of the CDC
Before Covid, the CDC was a nearly universally revered institution, with the reputation of conducting important research and interventions in epidemics in an admirably scientific manner. It received specific accolades for its role in containing the Ebola virus in Africa. Although funded by Congress and answerable to the president, it was basically independent of outside political influence, run by physicians and scientists who could set agendas on pressing public health needs.
This changed with Covid. The president castigated the CDC director for painting an early pessimistic analysis of the severity of the Covid outbreak. Soon critical decision-making about the epidemic became increasingly politicized. Lay people had an outsized influence on scientific questions such as masking, an issue that found liberals wearing them in greater proportions than conservatives.
And vaccination. Despite solid science that demonstrated the safety and effectiveness of the Covid vaccines, political persuasion trumped data, and vaccination rates were much higher on the political left than the right. This is true to this day, and mortality rates from Covid are at least two and a half times in the unvaccinated as compared to the vaccinated.
Cable news was rife with political commentary. The administration’s future (and now former) FDA commissioner wondered whether we might not be better off without the CDC. He later declared that the CDC is a “broken” agency.
The CDC was not flawless. For instance, it betrayed a degree of institutional sclerosis in regard to tests for Covid: the CDC produced an unreliable test for the virus early on, while universities were coming up with accurate testing. At first, the CDC impeded the release of these more accurate tests.
And messaging from the CDC was often confusing and contradictory. Apologists, however, point out the amount of unknowns early in the pandemic, with changing information coming almost daily, all of which made decision-making particularly difficult.
Current Challenges for the CDC
Under the current administration, and especially with the Department of Government Efficiency, the CDC has lost 30 percent of its employees, and threatened budgetary cuts approach 50 percent. The focus of the CDC has been narrowed to infectious diseases only, and entire areas of research have been eliminated or severely curtailed. For instance, the CDC no longer prioritizes chronic diseases, maternal mortality, and injuries. Injuries are the number one killer of children.
The Secretary of Health and Human Services, a noted vaccine skeptic, has replaced a vaccine advisory panel with political appointees, most of whom have no scientific background.
Dr. Susan Monarez, a microbiologist, was appointed as director of the CDC in the summer of 2025. 29 days into her tenure, she was fired for refusing to pre-approve politically driven vaccine recommendations.
Budget cuts to the CDC were overtly political. Over $600 million in CDC grants were interdicted in Democratic led states (California, Colorado, Minnesota, and Illinois), although a judge issued a temporary restraining order, noting that funding was the responsibility of Congress, not the administration.
The Future
There is no question that the CDC, like all bureaucracies, deserves organizational scrutiny. But its major current challenge is to wrest its mission from political control back to science and restore the hard won confidence of the public.
Stupid statements seem to be the coin of the realm in today’s political discourse: intemperate declarations such as “defund the police” are matched by the FDA’s commissioner’s obtuse musings on closing the CDC. The newly confirmed commissioner has excellent scientific and medical qualifications. I hope she has the political skills to meet the headwinds the current political environment presents.