The hollowing out of the CDC

During a tour of the Centers for Disease Control and Prevention (CDC) in Atlanta on March 6, President Trump declared: “The CDC has been proactive and prepared [for COVID-19] since the very beginning…They saw there was something going on in China before anybody even heard of it…That’s when they started working on this, and that’s pretty incredible.” Asked by a reporter if he had “confidence in the CDC” given the defective testing kits it initially prepared, the president said, “These are fantastic people… And the tests are beautiful. Anybody that wants a test can have a test. So, I think they’ve done a great job.”

In mid-May, Peter Navarro, White House Trade Adviser, made a different and more accurate assessment: “Early in the crisis,” Navarro indicated, “The CDC which really had the most trusted brand around the world in this space, really let the country down with the testing. Because not only did they keep the testing within the bureaucracy, they had a bad test and that did set us back.” By then, President Trump was urging protesters to ignore CDC guidelines for reopening the economy and “liberate” their states.

Lost amidst the serial boasting and blasting, however, was a game-changing reality: the hollowing out of the CDC by the Trump administration.

Partisan political considerations and an assault on science, it seems clear, have played pivotal roles in Team Trump’s choice of CDC directors. Appointed in July 2017, Brenda Fitzgerald was a doctor, specializing in gynecology and obstetrics, a political activist, who had run unsuccessfully for the Republican nomination for a Congressional seat in Georgia in 1994, and an ally of Newt Gingrich. Apparently, Fitzgerald had promoted “anti-aging medications” to her patients, a practice other physicians characterized as “unscientific” and “snake oil.” During her tenure as Georgia’s Commissioner of Public Health (2011-2017), the state’s overall ranking in public health dropped from 37^th to 41^st. Critics suggested that her relationship with Coca-Cola may have played a role in the absence of references to sugar during her anti-obesity campaign. Fitzgerald resigned as CDC Director in January 2018 following revelations that she had purchased shares in tobacco, drug, and food companies while serving as the nation’s top public health official.

An internationally recognized virologist and HIV researcher, Robert Redfield, Fitzgerald’s successor, has also been embroiled in controversy. In the mid-1990s, a military tribunal cleared Redfield of allegations of “sloppy and possibly deceptive analysis” in a clinical trial of a possible HIV vaccine at Walter Reed Army Institute for Research. But the panel chastised him for a relationship with the Children’s AIDS Fund (an organization that champions abstinence only education) that was “close to a degree that is inappropriate.” Redfield has subsequently declared that his plea to “reject false prophets who preach the quick fix strategies of condoms and free needles” was a mistake. Although he claimed “the data is clear” — condoms and needle exchanges “work” — Redfield still sat on the board of the Children’s AIDS Fund when he was named CDC director.

More important, the Trump administration’s war on science (which has contributed to the decision of more than 1,600 scientists to leave the federal government in the last three years) manifested itself in efforts to starve public health agencies. In 2017, Trump proposed to cut the budget of the National Institutes of Health by 18 percent and the CDC by 17 percent, which would have given the latter its lowest level of funding in 20 years. Specific cuts included $333 million in programs to fight infectious diseases; $136 million in the CDC Office of Public Health Preparedness and Response; $76 million to the Center for Global Health. As recently as Feb. 10, 2020, following briefings about the pandemic, the president’s budget included a 16 percent cut to the CDC. “The truth is,” Dr. Redfield acknowledged, “we’ve underinvested in public health labs. There’s not enough equipment, there’s not enough people, there’s not enough internal capacity, there’s no search capacity.”

President Trump’s defense of the cuts helps explain the federal government’s belated and inadequate response to the Coronavirus: “Rather than spending the money,” he said, “I’m a business person. I don’t like having thousands of people around when you don’t need them. When we need them, we can get them down very quickly.”

During his visit to the CDC, Trump claimed he “completely understood” all the issues related to COVID-19. “Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability.”

It leads you to wonder if maybe, just maybe, natural ability, even when it comes from a stable genius, isn’t enough.

Glenn C. Altschuler is the Thomas and Dorothy Litwin Professor of American Studies at Cornell University. He is the co-author (with Stuart Blumin) of Rude Republic: Americans and Their Politics in the Nineteenth Century.