GAO says restructuring aided CDC crisis management

A redesign of the management structure at the Centers for Disease Control and Prevention has improved the agency's ability to respond to a public health crisis, according to a new General Accounting Office report.

Health officials have made structural improvements at the top levels of CDC, including the creation of an emergency preparedness and response office and the development of an emergency communication system, the GAO found. During the 2003 worldwide outbreak of Severe Acute Respiratory Syndrome, the new emergency office "successfully coordinated the response efforts of CDC's various centers and [Office of the Director] staff offices," the report (GAO-04-219) said.

The watchdog agency also praised the CDC for creating a chief operating officer position with oversight of financial management and information technology.

The report, however, criticized the lack of oversight on "nonemergency public health work."

According to GAO, the "extraordinary demands" on CDC Director Julie Gerberding's time make it impossible for her to keep close watch on the agency's 11 independent centers. Below Gerberding, the GAO said, oversight is unclear or ineffective.

"Few formal systems are in place to track the status of the Centers' activities and develop strategies to mitigate adverse consequences," the report said. The Office of the Director "has not established its own criteria specifying the type of matters warranting management input."

In its response to the report, the CDC said that reform efforts are currently under way.

Those efforts, the CDC said, "can require at least five to seven years to complete."

The GAO auditors acknowledged that the CDC has several initiatives in development. In June 2003, the CDC launched an agencywide strategic planning process to set priorities and focus its work. In April 2003, the CDC started working on a comprehensive human capital plan, but that work has been suspended. The GAO report encouraged agency officials to resume the effort.

GAO also recommended that health officials clarify the roles of CDC deputy directors and implement "reporting requirements and tracking systems" for the centers.