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Congressional investigators call for CDC management changes

Emergency Management Alert, February 4, 2004

The General Accounting Office (GAO) said January 30 that the Centers for Disease Control and Prevention (CDC) should change its management structure to prevent programs from suffering when public health emergencies arise, the Associated Press reports.

The GAO, the investigative arm of Congress, praised the CDC's improved response capabilities, but also criticized the agency for sometimes duplicating assignments and having an unclear chain of command. CDC officials acknowledged the concerns but said the review occurred prior to Julie Gerberding's confirmation as director in July 2002. After taking her position, Gerberding began a thorough review of the CDC, its structure, and mission.

The GAO noted that Gerberding has direct authority over 11 centers across the country that perform the bulk of the CDC's public health work. When an emergency occurs, such as anthrax or SARS, her attention and that of other top CDC officials is often diverted, leaving little time for the CDC to focus on non-emergency public health work and agency operations, according to the report.

The GAO recommends that those centers report to someone other than the director, perhaps in a newly created position. The GAO praised the recent addition to the CDC of a chief operating officer, who is responsible for financial management and information technology, but said improvements are still necessary.

The investigators cited an internal CDC document from October 2001 that concluded the agency was running four separate emergency operations centers, which created an uncoordinated command and control system. A top official in Gerberding's office told GAO investigators that during the anthrax incidents, there weren't formal leadership protocols in place for crisis management decisions.

The GAO report is available for download at http://www.gao.gov.

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