Even CDC Not Immune from Political Minders

by DemFromCT

The Cox News Service has a story in the Atlanta Journal-Constitution (Atlanta is home of the Center for Disease Control and Prevention, and the AJC covers them regularly) about the difficulty of filling important overseas posts, needed for emerging disease surveillance.

Facing a tangled bureaucracy and a lack of qualified staff, nearly half of the overseas jobs at the Centers for Disease Control and Prevention are vacant despite an urgent need to guard against foreign health threats. Many of the jobs will remain unfilled for another year, according to an internal CDC memo obtained by The Atlanta Journal-Constitution. "This is a critical time for global health," wrote Dr. Stephen Blount, director of the CDC's Coordinating Office for Global Health, in an April 13 memo to CDC Director Julie Gerberding. The potential of an influenza pandemic, the current HIV/AIDS pandemic and the threat of a bioterrorist attack from abroad "fuels the urgency to make overseas assignments in a timely manner," he wrote.

Ah, that potential of an influenza pandemic. Well, thank goodness for America that keeping us healthy and safe from disease is a non-political job. Oh, wait...

Only 166 of the CDC's 304 overseas positions in 53 countries are filled, according to the memo. At least 85 positions likely will remain unfilled until 2008, Blount said. Among the causes he cited: Delays at a federal human resource center in Atlanta and an additional bureaucratic layer that requires CDC foreign postings be approved by a senior political appointee's office in Washington.

What's that about? What does politics have to do with health?

One of those unique challenges, according to Blount's eight-page memo, is the CDC must request special approval for every overseas assignment from the HHS Office of Global Health Affairs. This adds an additional two to three months of delay in hiring staff for foreign postings, according to the memo. "Some positions have been delayed for so many months that our partners doubt our commitment and credibility," Blount wrote.

William Steiger, director of HHS' Office of Global Health Affairs, was out of the country and unavailable for comment, said spokesman Bill Hall. Steiger has come under fire in the past for allegedly micromanaging the overseas work of the department's scientific divisions. Steiger, the godson of former President George H.W. Bush, is President George W. Bush's nominee to be the next U.S. ambassador to Mozambique.

Hall did not respond to requests for other department officials to explain the hiring policies.

Jeff Levi, executive director of the Trust for America's Health, questioned why HHS officials in Washington are contributing to the CDC's hiring delays. "CDC isn't sending political people abroad to do global disease detection. They're sending scientists," said Levi, whose Washington-based group examines public health preparedness. Levi said having CDC scientists overseas is important in creating a stronger global disease detection system. The vacancies create the risk that "we won't get the warning we need and we won't be as prepared as we should be," he said.

U.S. Sen. Charles Grassley, the ranking Republican on the Senate Finance Committee and a CDC watchdog, said it's in the best interest of the world to get the positions filled. "We need to do what it takes to cut through red tape in the hiring process and encourage seasoned CDC leaders to fill important positions overseas," he said. "The global public health threats we face are high stakes."

Grassley has been all over the CDC lately because of morale and reorganization issues:

Former directors of the Centers for Disease Control and Prevention warned Tuesday that morale problems and questions of scientific integrity at the agency pose a challenge to the centers' future role in U.S. public health.

"Science is nothing without people," said Dr. William Foege, who ran the CDC from 1977 until 1983, "and there's a perception now that politics trumps science and truth."

"This is not just with FDA decisions or climate change or at EPA," he said. "We see this in public health as well."

Citing an example of politics dictating CDC decisions, Foege said that in April 2004, the World Health Organization requested the participation of CDC scientists at a conference on HIV/AIDS, and the office of then-HHS Secretary Tommy Thompson insisted on clearing the participants in advance. "CDC acquiesced in that, and politics trumped science in a way that I never thought would happen," Foege said. Foege appeared with four other former CDC directors at a symposium sponsored by the George Washington University School of Public Health. It was a rare public discussion of their concerns since most of them privately sent a letter to director Julie Gerberding more than a year ago.

This is painful to write about, as I'm sure it was for the former CDCers to discuss. The CDC is the crown jewel in the US public health system, and the bulwark against disease threat and risk. There are many fine and dedicated people who work (and have worked) there; I know many of them personally and and have collaborated with them on various projects over the years. Everyone in medicine looks to them for public health direction. For example, the very fact that CDC (rightly) considers an influenza pandemic a real and credible threat is why many have paid attention to the issue. 2008 will be a 'change' election. The practice of having political minders in every facet and level of government isn't just affecting science, it's potentially affecting the world's health. That is not an acceptable situation, and yet another thing that has to change. We need a public health system that's more in tune with the public's needs. And don't miss the references above to FDA and climate change and EPA. Elections have consequences, and it'll take years to clean up the mess the last two elections have caused in the worlds of health and science.

Comments

[earlofhuntingdon]

Sadly, the politics of this are obvious. To this administration, govt agencies are political tools. That they may have substantive functions, such as tracking or preventing disease, is either an opportunity or a threat, not a purpose.

Consequently, all foreign assignments are potentially dangerous. Foreigners, like the Chinese and the uncooperative French, revere scientists and give their statements great weight. For the equally uncooperative Germans, Herr Professor Doktor is a higher title than managing director or president (a sin in businessman's America).

The foreign press will pick up what these scientists say faster than their controlled American cousins, and give it more prominence, making it hard to get off message remarks back in the bottle.

Real scientists, for whom rationality is a reason for being, are likely to say things off message. Like, sexuality education and contraception are inherently necessary components of quality maternal and infant care programs. Or, of course we should test all cattle for BSE, not just the ones so sick they spit up and fall down like a Skull & Bones man. Or, absolutely, avian influenza virus could spread by transporting chicken carcasses from Hungarian abattoirs to UK storage facilities.

Imagine the collective strokes and heart attacks among the authoritarian religious right and the agribusiness, chemical and pharmaceutical industry executives. Imagine the angry phone calls to Karl that taxpayer funded scientists are hurting their businesses. Imagine the threats of cuts to contributions to the RNC.

Anyway. What the public doesn't know can't hurt it, can it?

[Bugboy]

CDC is not beneath playing political games of their own. There've been conveniently released studies, with accompanying pressers, right around budget time highlighting this disease or that.

I follow CDC professionally, have even been to the Atlanta facility and have had staff visit my offices. They do good work but they ARE an product of the process. But like any research institution, the scientists were never freelancing policy, at least not in my experience working with them. That was for administrators to do.

I myself was a political appointee at a small mosquito control district. I didn't, not for one second, entertained the thought of assisting any of my board members in their campaigns.

These guys are redefining what a political appointee is. Just like they keep saying "under law" like what Toensing keeps babbling. Just like Habeas Corpus being optional in Gonzo's mind.

They are attempting, successfully I might add, to redefine the paradigms so they can say "there is no spoon".