Post-pandemic, CDC faces ‘uphill battle’ for backing in new Congress

But there’s one major problem — she needs Congress’ help. And she is losing key allies.

CDC Director Rochelle Walensky argues that in order to make her agency more effective, it needs expanded authorities and capabilities. But congressional Republicans say they want more oversight.

Walensky said she’s amenable to such oversight and will testify whenever called. But she also wants to prove to lawmakers the importance of long-term public health funding.

This is the agency’s moment to “rebrand,” Walensky told CQ-Roll Call in a recent interview.

GOP members in both the House and Senate are loath to provide the agency with more money after several years of redirecting emergency funds to prop up pandemic efforts.

They say the agency mismanaged the vaccine rollout, masking guidelines and return-to-school policies, among other things. The CDC has admitted mistakes but argues it did the best it could under unprecedented circumstances.

In the House, the new Republican majority plans to subject Walensky to a barrage of scrutiny not previously seen from Democrats. Across the Capitol, the departure of Sen. Richard M. Burr of North Carolina, the lead Republican on the key Senate Health, Education, Labor and Pensions Committee, leaves the agency without a key Republican champion.

A CDC overhaul, announced in August, aims to revamp the large agency and streamline communication. It’s a long-term effort, and the agency has brought in new staff to begin implementing the changes.

But the mission is daunting: The United States is 80,000 public health workers in deficit, has crumbling public health laboratory infrastructure and poor data-sharing capabilities, Walensky said.

The agency has had to repeatedly ask Congress for emergency pandemic funding, and Congress is increasingly reluctant to fulfill those requests. Most recently, the Biden administration asked for $10 billion more for short-term needs — the fourth request the administration has made this year alone. Like the prior three requests, there’s little momentum in Congress to fulfill that ask.

Walensky said she doesn’t want to keep asking Congress for emergency funding. Instead, she argues, Congress should commit to steady annual public health funding.

“The fascinating thing about public health is that what works, it shouldn’t be part of your everyday dialogue. And that is a hard way to get funded,” Walensky said.

At its core, the CDC is an agency charged with protecting American public health and tracking the spread of diseases. But now, as the agency looks to reorganize and correct mistakes made during the COVID-19 pandemic, it’s unlikely to shed its reputation as a political agency, experts say.

The agency’s troubles preceded the Biden administration. Former President Donald Trump’s laser focus on the public health agency, and occasional public chastising of scientists, planted a seed of mistrust in the agency.

But public trust in the CDC continued to decline between December 2020 and April 2022, according to polling from the Kaiser Family Foundation.

Walensky knows regaining that trust will take work.

“A lot of what I feel like the work of moving forward is to demonstrate where we are in the science, where we are in delivering to the American people and redeveloping that trust,” Walensky said

Before the pandemic, the CDC enjoyed relatively high levels of support among the American public, but the challenges that stemmed from the pandemic could impact its long-term credibility, said J. Stephen Morrison, senior vice president at the Center for Strategic and International Studies, a national security-focused think tank. Morrison is currently researching the CDC reorganization effort.

“They’ve lost a lot of trust with the American people that they need to come clean,” said Kentucky Sen. Rand Paul, a prominent Republican on the HELP Committee and reliable adversary of Walensky’s. “And the bottom line is people need to have some answers.”

Incoming HELP ranking Republican Bill Cassidy, R-La., is less critical than Paul. He questions some of the agency’s internal workings, like its remote work policy, but said his goal is to help the agency succeed.

“I’m very amenable to working with CDC. But there has to be more accountability, more than ‘trust us,’” Cassidy said.

The CDC needs Congress’ help — and money — to fix some internal issues, especially when it comes to collecting data, Walensky said.

She points to the U.S. response to mpox, formerly known as monkeypox, as evidence. The U.S. reported its first case of mpox on May 17 and the agency had its vaccination strategy in place by June 28, but it took until Sept. 1 for the agency to access data on how the vaccination had been administered.

That’s because the agency had to work individually with the legal offices from 61 states and jurisdictions before collecting vaccine data.

“Nine weeks. We were allocating a scarce resource without seeing who was getting it. That’s too long,” Walensky said.

Congress has already provided the agency a total of $1.1 billion to update its data capabilities since the start of the pandemic, via two different COVID-19 relief bills.

Cassidy knows the agency wants more money to update its data streams and says he will work with them to get it done. But he said the agency needs to first demonstrate what it’s been doing with the money it’s been given.

“There needs to be a little bit of transparency with what they’ve done. … I mean, if you want more capabilities, you should be able to open up your books and say, “This is what we’re doing,” Cassidy said.