Julie Gerberding Fights Back
The CDC’s head has an answer for her agency's critics.
Tim Darnell
October 1, 2007
For an organization whose official goal is “to promote health and quality of life by preventing and
controlling disease, injury, and disability,” the CDC has received a lot of bad press lately. From
power outages to reports of misplaced equipment, the Centers for Disease Control and Prevention
has, over the past year, seen an unprecedented barrage of unfriendly headlines aimed squarely at
its smocks.
But Dr. Julie Gerberding insists the entire story isn’t getting out. The CDC and its director
are undertaking a renewed and concerted effort to make sure, in her words, a “fair and balanced”
portrait of the agency is disseminated in the media. Not only that, but she’s reaching beyond the
too-often-stifling bureaucratic mindset and guidelines into a constituency the CDC needs to make it
a better-managed organization: you.
“This is a great agency, but its not perfect,” Gerberding says, in an exclusive interview
with Business to Business. “When we make a mistake, we say we made a mistake and then we fix it.
But challenges arise when people allege mistakes that weren’t made or when they’re not presenting
issues fairly. It puts us in a defensive posture, and now we’re reassessing our strategy and being
more proactive in setting the record straight. We can’t let someone else tell our story for us.”
Gerberding has been
director of the CDC for just over five years now, and she’s the first to admit her organization is
going through a major transition from primarily a domestic-oriented agency to one with major global
health care initiatives. With that transition comes big challenges in terms of management,
organization and globalization – not to mention trying to push, pull and heave a mountainous
federal bureaucracy into the year 2007 and beyond – and that’s one reason she is stressing to
Atlanta’s business community the enormous opportunities in public and employee health and safety
existing right here.
“I would love it if Atlanta’s business community would take advantage of the fact they are
working in the health protection capital of the world,” she says. “CARE International is here; the
American Cancer Society is here; the Carter Center is here; Emory and Morehouse are here. But when
the [Metro Atlanta] chamber [of Commerce] was advertising the city as a place to do business, no
mention of those assets was made. Now is the ideal opportunity for businesses to take advantage of
us, and get us involved in the health and safety of their workforces and the community’s.”
Slow to adapt to a digital world
The challenges facing the CDC – and the bad headlines that result – are primarily managerial
and logistical. Recent reports the CDC had lost or misplaced equipment, Gerberding says, are the
result of snail’s pace documentation procedures that simply don’t work in today’s warp-speed
digital world.
“Nothing has been stolen or is missing,” she says. “The problem isn’t with missing inventory,
but missing documentation. The government inventory system we use requires us to annually account
for real property. The system we’re using was designed a long time ago, when we were very small. We
haven’t armed our inventory custodians with the latest Web-based interfaces that allow them to do
their job better. We have no property that is undocumented, but it takes time for the documentation
to catch up with the equipment.”
Compounding the problem is the fact some of the equipment is located in overseas CDC
locations, places where outdated U.S. government inventory technology doesn’t exactly jibe with the
local infrastructure. “The bottom line is, this shouldn’t have happened, and the silver lining is
that we’re going to get a system that works better for us. But the reports of this problem have
been grossly overstated.”
The other controversy making recent local headlines was a power outage that occurred at a CDC
infectious disease lab. A lightning strike and power surge knocked out power to the $214 million
building, but remote backup generators never came on, thus shutting down air pressure systems used
to protect scientists – and the public – from bacteria and viruses.
After the incident, the Atlanta Journal-Constitution obtained a series of internal government
communications and e-mails in which officials warned the CDC’s backup electrical systems were not
sufficient to protect lab systems during a power outage.
Lightning strikes
So what exactly happened? “Lightning struck,” Gerberding says. “The building is designed with
a lightening diffuser to bring bolts of electricity down to the ground and diffuse them. But
because there was construction going on next door, the construction inadvertently interfered with
the ground circuit that prevented the electrical charges from entering the building. That tripped
the circuit breaker. The backup generator didn’t kick in because [the power outage] only affected a
limited part of the facility. No science was going on in that area, and there was no threat to
anyone.”
Still, Congress is examining safety at the nation’s bioterror labs – including the CDC – and
the House Energy and Commerce Committee was expected to meet either last month or this to examine
safety and security issues at such labs.
Gerberding also seems to fight an ongoing, never-ending battle to ensure Congress funds CDC
initiatives from top to bottom. “We are way under-invested in the business services that support
our globalization,” she says. “Congress is naturally inclined to spend money on programs. Spending
X amount on Y problem sounds good, but it doesn’t sound as good to say X amount needs to go to
infrastructure or to support for indirect functions in solving Y problem. It’s the same thing when
you support a charity: You’re excited about fighting cancer or heart disease, but when you see high
percentages going to support the organization and staff …
“But I’m absolutely convinced the amount we’re spending is way too little to support our
globalization properly. And we are working to make a business case for it. As an agency, we’re able
to support major health initiatives like polio eradication and battling malaria, but we spend a
relatively low amount on business development and infrastructure.”
Under fire
On Sept. 1, 2001, Gerberding recorded her first day as acting deputy director of the National
Center for Infectious Diseases, located at the CDC’s Clifton Road campus. Eleven days later, she
was running to every lab on the campus, after the FBI had recommended the agency’s evacuation in
the wake of the terrorist attacks.
“We had no overhead system to warn people, and no capacity to evacuate the campus,” she says.
“Since then, the agency has been in emergency response mode 33 times: anthrax, West Nile, SARS,
vaccine shortages … We’ve had a dramatic expansion of our mission to encompass public health care
initiatives.”
But for what Gerberding likely will be more remembered is the CDC’s major restructuring and
reorganization on her watch. When Gerberding took the helm in July 2002, the agency had a strategic
plan that dated back to 1970. Its budget was about $300 million and employed 4,000 people; today,
CDC’s combined workforce (employees and contractors) is approximately 15,000, financed by an $8
billion budget.
But as the agency’s budget and number of personnel grew, the amount of communication between
its different divisions didn’t. The CDC’s big strategic reorganization includes the creation of
four new coordinating centers and two national offices, which Gerberding hopes will help it more
efficiently deal with 21st-century health threats.
The five-year strategic reorganization plan was formally put into practice in 2005. The
structure includes the creation of four new coordinating centers – the coordinating centers for
environmental health and injury prevention; health promotion; infectious diseases; and health
information and services – and two new national centers, one for public health informatics, and the
other under the title of health marketing.
Looking for answers
“First we asked ourselves, what do we do well?” Gerberding says. “Well, we do laboratory work
very well, and active investigations. [But] we don’t have a long history of large-scale operational
planning, logistical support and execution, complex, enterprise-wide project management. We couldn’t
build those things from scratch, so we asked, where can we find these things?”
One of those answers, Gerberding says, is business, which she says the CDC has always enjoyed
close ties to (see sidebar: A link to the private sector). “The difference now is the awareness we’r
e all in this world together,” she says. “We’re recognizing the CDC can’t accomplish its public
health goals without partnering with business. And businesses are recognizing the importance of
public health, and are coming to grips with rising health care expenses. It’s an evolving target.”
With the new coordinating centers, Gerberding hopes scientists will be better able to share
their expertise to solve public health problems and emergencies; streamline the flow of information
for leadership decision-making; and better leverage the expertise of partners. “Any corporation or
large organization will tell you, realignments are tough to achieve,” she says. “The exciting part
are the payoffs we’re already seeing as we emerge as a modern, flexible, goal-oriented agency.”
The CDC also is trying to meet 21st century challenges such as new technology, complex
information flow and rising health care costs. Changes include modernizing its management and
accountability to save money that can go directly to science and programs. CDC has reallocated more
than 600 open positions from administrative tasks to direct research and programs, such as
epidemiologists, medical officers and laboratorians.
Recently, the agency has reduced administrative costs by more than $83 million and made these
resources available for frontline projects that directly benefit health. Finally, CDC will save $35
million over seven years to improve its customer service by consolidating 40 separate information
hotlines into a single hotline.
The CDC also is working inside corporate environments through incubators. “If your company
really wants to support your workforce’s health and safety, where’s the best value? What’s the most
critical thing you need to do? We’re working on that here,” Gerberding says.
“When people talk about health care reform, they’re mostly referring to health care delivery
system reform and cost drivers,” she adds. “Businesses have a very strong stake in that. And we’re
seeing the best companies right now going green but also going lean.” She recently participated in
a roundtable seminar centered around pandemic preparedness with some corporate executives, “to
learn more about what we need to do to support their own corporate preparedness. Executives are
helping educate us about what they want or need from the CDC.”
Leading a mammoth federal agency is akin to having three jobs at once, Gerberding says. “I
have a job to represent the CDC before Congress, a job as a public health diplomat, and a
here-at-the-campus job,” she says. “At least once a month I try to sneak into a lab for half a day.
That’s the best thing I do. I like to spend as much time with emerging leaders, young people. They’r
e very positive; they have great ideas, and we have to help them develop.”
The CDC’s reorganization now enables Gerberding to meet with 14 department heads on a weekly
basis to keep track of the agency’s initiatives, programs and investigations; weekly meetings that
Gerberding says she would have to be far out of touch with people and technology to miss. “That’s
the most important part of my week,” she says, and those meetings are a crucial component in
planning and organizing future CDC endeavors.
Gerberding also is considering opening up the CDC’s doors a bit wider to the business
community, “showing people what we can do, and the support systems we have for corporate exchange
programs. We can put a CDC expert into a business environment, or host an executive on a sabbatical
who wants to spend time at the CDC and learn about sharing agendas and technical capabilities.
“Businesses in Atlanta are really suffering in terms of health expenses for their workforce,
and part of the solution is sitting right here in Atlanta. It’s up to us to make those connections.”