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News / Health / Health Wire

Outgoing CDC chief Rochelle Walensky: We need help to be ‘nimble agency of the future’

By Donovan J. Thomas, The Atlanta Journal-Constitution
Published: July 2, 2023, 6:02am

Dr. Rochelle Walensky is preparing for life after the pandemic. She announced her plans to step down as head of the Centers for Disease Control and Prevention on May 5, just six days before the federal government declared the end of the public health emergency.

Walenksy’s tenure of just under two and a half years as head of the nation’s lead public health agency was one of the shortest of any CDC director. It was also marked by contentious political fighting over pandemic public health policies.

She led the country’s coronavirus vaccination effort, the response to last year’s outbreak of mpox (formerly known as monkey pox), as well as a reorganization of the 13,000 person agency, while under fire from officials and the general public. As part of her work to change how the agency operates, she launched CDC Moving Forward, which is a blueprint for modernizing and streamlining the agency’s practices to better protect and inform the public.

While Walensky does not know what is next for her, she looks forward to spending more time with family, hitting the gym and getting back into reading for leisure.

The Atlanta Journal-Constitution spoke with Dr. Walensky as her time leading the CDC winds down. This interview has been edited for length and clarity.

Q: The announcement of your resignation seemed unexpected. Do you feel like your work at the CDC was done?

A: We’ve done an extraordinary amount of work in moving the agency forward to be the public health agency of the future that Americans deserve. That effort has been going on over the last year. With the end of the public health emergency and feeling like we were in a really good place with CDC Moving Forward. … Our science was moving faster, our communications were getting out.

What became very clear to me is that the work of CDC Moving Forward was not going to be a single person’s tenure. It was going to be a mindset as to how our civil servant leaders were going to have to think about the CDC and how we’re both a science- and response-based agency in the future. With that and the end of the public health emergency, it felt like it was time to provide that opportunity to somebody with renewed energy.

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Q: The worst of the pandemic seems to be past. What should CDC and other public health agencies be doing right now to prepare for the next one?

A: I sure hope you’re right, and the worst is behind us. I will say that even with the end of the public health emergency, CDC’s work and effort in COVID-19 and other respiratory viruses in general have not let up. We still have a team of people who are working, who are giving situational reports to me frequently. We are following those very carefully because our job is to worry about things when everybody else is no longer worried about it.

We do need help from Congress to be the nimble agency of the future. While we are expected to be a response-ready agency and we are doing that work to become one, we don’t have all the authorities that a agency like FEMA has. A lot of the work will be to not only do the work inside the agency, but to work with Congress to have the authorities so that we can be the response-ready agency that’s expected of us.

Q: Much has been said about the difficulties that you have encountered with political interference with how the agency is run. What’s your advice for Dr. Mandy Cohen, your successor, on this?

A: How I led the agency is through a foundation of science. Obviously we in public health recognize that when policy is made that happens at the intersection of science and many other things like education, economy and transportation. Health has to be a very important seat at the table, but it can’t be the only seat at the table because people value all of these things in different ways.

My advice to her would be to sort of keep your head down and recognize that the science has to be the foundation of what we deliver in health. … Health does not happen in a vacuum, we have to consider at a policy level all of these other things that are happening.

Q: You touched on the CDC Moving Forward Initiative and part of that initiative was bringing health equity to the forefront of conversations and policies in public health. What strides towards advancing health equity that you’ve made as CDC director do you think will have the longest lasting impact?

A: Yes, it is truly part of our CDC Moving Forward effort, but I do want to say that this is probably among the biggest things that I did early on. We declared racism a serious public health threat in April (2021), two and a half months after I started and recognized in all of our work across CDC, equity just had to be baked into every single thing that we are doing.

One of things that I asked the agency to do was to not just document the problem. Every time we look for disparities in healthcare, we find them. So while we may need baseline data, we have to go beyond just documenting the problem and understanding what needs to be solution-based actions.

I want it to be very clear that we couldn’t say at the end of a notice of grant award, “Don’t forget equity.” We needed to weave it in. In fact, we’ve woven equity into all of our funding announcements and grant awards. That has been critically important and invigorating for the agency, and I certainly hope one of the legacies that will live after I’m here.

Q: What do you think is the greatest challenge facing public health currently?

A: I think we’ve made a huge amount of strides in our public health infrastructure over the pandemic. Our data modernization efforts have been catapulted during the pandemic, but we still have a lot of work to do. When we talk about electronic case reporting, we had 187 health facilities reporting electronically to the CDC before the pandemic. We now have over 25,000 — extraordinary progress. That’s still only 20 percent of healthcare facilities. So, we have a lot of work that we still need to do in our data modernization, making sure our data highways connect.

We also have workforce challenges. There have been some who estimate that we are at 80,000 public health workers in deficit to just do the fundamental expectations of public health across this country. Then, finally, laboratory infrastructure. I would invite anyone to go their state health lab and see if it has all of the skilled professionals and technological equipment that is needed to be the public health lab that states need and expect.

So, I think we still have a lot of investments (needed) in public health infrastructure. It is real painful to think about the dark days of the pandemic. It is much easier to forget them and to be appreciative that they are behind us. But, if we don’t recognize that we started with a frail public health infrastructure, then we will not make the necessary investments to get beyond that frailty.

Q: Is there anything that you look forward to getting back into now that you might have a bit more time on your hands?

A: I’m very much looking forward to spending more time with my family, reading a few books — I haven’t been able to pleasure read for a long time — and heading to the gym. Just sort of spending some time reflecting on what an incredible three and a half years this has been. Two and a half with the CDC and the year prior on the frontlines.