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What Exactly Does the CDC Do?

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Robert L. Quigley, MD, DPhil, is the Senior Vice President and Global Medical Director, Corporate Health Solutions at International SOS & MedAire. After 25 years working in surgery, critical care, and immunology, he's using his expertise to advise on crisis management, infectious disease, and health care. Here, he shares what you should know about how the CDC does—and doesn't—operate.

While the Centers for Disease Control and Prevention (CDC) has been around for decades, it may feel as if they have become more prominent since the rise of the COVID-19 global health crisis. Although some people may be generally familiar with the CDC, it’s not surprising that many do not fully understand the roles, responsibilities, and authority that the CDC has within the U.S., as well as the work the organization does to save lives and protect people worldwide. 

Almost 75 years ago in Atlanta, GA, the "Centers for Disease Control" began as a branch of the U.S. Public Health Service. The CDC was first tasked to address malaria, which was endemic in the Southern U.S. at the time.

Today, the CDC answers to all three branches of the US government: legislative, executive, and judicial. In 1992, Congress, while keeping the CDC acronym, designated the organization be called the Centers for Disease Control and Prevention, expanding its power as one of the major operating components of the Department of Health and Human Services (HHS). In this capacity, the CDC has protected public health and safety through infectious disease surveillance as well as the prevention of disease, injury, and disability, both domestically and worldwide.

We now know that disease knows no borders. Through its worldwide footprint, the CDC focuses not only on eliminating disease and ending epidemics—disease outbreaks limited to a particular region—but on pandemic preparedness as well. COVID-19 has certainly tested the CDC's abilities in this area.

What's the Difference Between the CDC and the WHO?

Just like the CDC, the World Health Organization (WHO) is involved in global efforts related to infectious disease surveillance, elimination, and preparedness. The WHO is a United Nations agency that answers to the annual assembly of the world’s health ministers.

The CDC relies on advice from its internal experts while the WHO convenes panels of independent experts from around the globe. The WHO has an ambitious vision to improve the health of every global citizen through programs beyond infectious disease control, such as protecting the environment from manmade damages. The CDC, on the other hand, has a primary focus on the health and safety of American citizens.

The CDC and the WHO work together to coordinate and implement public health programs globally. For example, in 2016, both organizations advised that pregnant women, or those wanting to become pregnant, should avoid travel to regions with Zika transmission.

However, because these two organizations are structured differently in their execution strategy for disease management/mitigation, there is always the potential to create conflict and confusion during a health crisis like COVID-19.

Both the CDC and the WHO did agree on COVID-19 mitigation best practices such as social distancing, washing hands, and mask wearing. They did not agree, however, on which types of COVID-19 testing tools were most appropriate, at least at the start of the pandemic.

Since the CDC is a governmental agency, it can take action within the U.S. during a health emergency. The WHO can only make recommendations. 

The CDC is continuously working on corralling information on new variants of the COVID-19 virus. It has also launched V-safe, a tool used to determine and identify safety issues with vaccines. Findings from efforts like these are used to guide CDC COVID-19 recommendations. It is then up to the individual governments to act upon them or not.

What Can the CDC Do Better?

The COVID-19 pandemic has certainly challenged the CDC and other health organizations worldwide, and while the organization has risen to many challenges, it is clear there are opportunities to learn from the pandemic and prevent similar situations in the future.

Now that the vaccines have been made widely available in the U.S. and their efficacy is proven, the CDC needs to include a coronavirus mitigation strategy for the future. 

For more than 50 years, the CDC has been a part of the global influenza surveillance and response system (GISRS)—a process to monitor the ever-changing mutating influenza virus. The organizers meet twice annually to recommend which influenza strains should be included in the next year's vaccines.

A similar system should be created to conduct coronavirus surveillance globally and make similar recommendations as to which coronavirus strains should be addressed in the next year's vaccines. Those vaccines would then need to be approved by the Food and Drug Administration, FDA, (another agency within HHS protecting public health).

A few organizations have already recommend global surveillance strategies. The Rockefeller Foundation introduced the Pandemic Prevention Institute in June 2021. However, a collaborative global approach between neighboring countries will be essential to keeping COVID-19 at bay.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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