Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention: A Pillar of Public Health

Imagine a fortress standing tall against the ever-present threat of disease—this is what the Centers for Disease Control and Prevention (CDC) represents. As a US federal agency under the Department of Health and Human Services, headquartered in Atlanta, Georgia, the CDC’s mission is to protect public health and safety through disease control and prevention.

Their journey began in 1946 as the Communicable Disease Center, a successor to the World War II Malaria Control program. With an initial budget of $1 million, their primary focus was mosquito abatement and habitat control to eradicate malaria in the US. Over six and a half million homes were sprayed with DDT during its early years, marking the beginning of a long and complex history.

As we delve into the CDC’s evolution, it becomes clear that this agency has grown from a small operation focused on one disease to a comprehensive organization addressing over 400 diseases. From infectious diseases like smallpox and influenza to non-infectious ones such as obesity and diabetes, the CDC’s scope is vast.

But what makes the CDC truly remarkable is its adaptability. In recent years, it has undergone significant changes in response to the challenges posed by the Covid-19 pandemic. These changes include reorganization efforts, annexation of property, and a major overhaul of data analysis and communication practices.

One notable event was when the CDC ordered its staff to stop working with the World Health Organization due to an executive order from Donald Trump. This decision led to the pausing of certain research publications and even the halt of the Morbidity and Mortality Weekly Report (MMWR) for the first time since its inception in 1960.

These actions sparked controversy, with around 1,300 CDC employees being laid off. The agency’s response to these challenges highlights the delicate balance between scientific accuracy and political considerations—a tension that has eroded public trust at times.

The Structure of the CDC

Organized into centers, institutes, and offices, each unit within the CDC implements activities in a particular area of expertise while providing intra-agency support and resource-sharing. The agency’s budget for fiscal year 2024 is $11.581 billion, employing approximately 15,000 personnel, including contractors and Public Health Service Commissioned Corps officers.

The CDC has a presence in various locations across the US, with most centers based in Atlanta, Hyattsville, Maryland; Cincinnati; Morgantown, West Virginia; Pittsburgh; Spokane, Washington; and Washington, D.C. Additionally, it operates quarantine facilities in 20 cities nationwide.

Key Programs and Initiatives

The CDC’s programs address a wide range of diseases, from communicable ones like smallpox and influenza to non-infectious conditions such as obesity and tobacco use. Notably, the agency has a National Action Plan for Combating Antibiotic Resistant Bacteria with a budget of $161 million.

Globally, the CDC works on international health challenges through partnerships with organizations like the World Health Organization (WHO). It maintains staff in over 60 countries and implements initiatives such as the International Health Regulations and President’s Emergency Plan for AIDS Relief. The agency also publishes travel health notices and issues warnings about diseases that may affect travelers.

For vaccine safety, the CDC uses tools like VAERS, Safety Information by Vaccine page, Vaccine Safety Datalink, and Clinical Immunization Safety Assessment. These systems ensure that vaccines are safe and effective for public use.

The CDC Foundation

The CDC Foundation is a private, nonprofit organization operating independently from the CDC as a 501(c)(3) organization. It supports the CDC’s mission in partnership with the private sector and has raised over $1.6 billion to launch more than 1,200 health programs worldwide.

The foundation engages in research projects and health programs focused on various issues, including cardiovascular disease, cancer, emergency response, and infectious diseases. However, it has faced criticism for its involvement in controversial studies, such as the Tuskegee syphilis study and the Dickey Amendment, which restricts CDC funding for gun control research.

Challenges and Controversies

The CDC’s handling of the Covid-19 pandemic has been a source of significant controversy. Early test malfunctions led to delays in widespread testing, and the FDA found that the CDC had violated protocols in developing tests. The agency also conflated test results, released faulty test kits, and altered the writings of scientists about COVID-19 recommendations.

In February 2025, the CDC ordered its scientists to retract research that included certain banned terms related to gender and identity. This directive led to widespread censorship of government and private publications, with some researchers preserving their own databases on archive sites like the Internet Archive.

A federal lawsuit was filed against the CDC, FDA, and HHS, citing the removed materials as vital for real-time clinical decision-making. The controversy over the Morbidity and Mortality Weekly Report (MMWR) further highlighted the agency’s challenges in balancing scientific accuracy with political considerations.

The Future of Public Health

As we look to the future, the CDC faces an uphill battle in restoring public trust. The agency must navigate complex issues while maintaining its commitment to protecting public health and safety. Will it succeed? Only time will tell, but one thing is certain: the CDC’s role as a guardian of public health remains crucial.

The future of public health depends on the CDC’s ability to adapt, innovate, and maintain its integrity. As we move forward, let us hope that the CDC can continue to be a beacon of hope in the face of disease and uncertainty.