Download This PaperProgram Evaluation as a Strategic Instrument for Reforming the Centers for Disease Control and Prevention
139 Pages Posted: 14 Feb 2024 Last revised: 1 Mar 2024
Date Written: February 11, 2024
Abstract
In this manuscript, we conduct a thorough review of the Centers for Disease Control and Prevention’s (CDC) initiatives and cooperative agreements and utilize program and budgetary evaluation as a pivotal instrument for elucidating avenues for reform. Cooperative agreements (CA) and CDC initiatives (CI) in alignment with CDC’s foundational domains in communicable diseases, epidemiological response, and public health preparedness and response were identified and marked for expansion. In this vein, programs not in alignment with these foundational domains were marked for transfer to other federal entities or for elimination entirely, especially if they represented duplication of efforts within the federal government or private sector. For instance, overdose prevention programs are proposed to be consolidated within the Substance Abuse and Mental Health Services Administration, leveraging its existing network of State, Local, and Territorial Health Entities (STLTHE), rehabilitation centers, and harm reduction programs. The designs of future CA need to incorporate implementation flexibility in light of public health exigencies, infrastructure needs, infectious disease challenges, and emergent concerns at the local level. A potential solution lies in deconstructing the existing convoluted program-specific cooperative agreements funding architectures and reallocating these funds as per-capita grants to local health entities with contingencies based on needs-assessment markers such as the social vulnerability index, ensuring a more equitable and responsive public health funding landscape. The proposed programmatic changes are designed to facilitate this transformation, and steering the CDC away from its current trajectory as an academically inclined bureaucracy back to its action-oriented roots, responsive to front-line public health crises.
Funding:
Drs. Cullen, Phan, and Ranasinghe report no funding for this work. Dr. Miller and Dr. Gowda report receiving grant support from the Charles Koch Foundation, which had no role in this work.
Competing interests:
Dr. Gowda has no other competing interests to report. Dr. Ranasinghe reports serving on the AMA Council on Science and Public Health. Dr. Phan reports receiving grants support from the National Institute on Drug Abuse and the National Institute on Aging, which have no role in this work. Dr. Cullen has no other competing interests to report. Dr. Miller reports unrelated grant support from Arnold Ventures, the Ohio State University, and the Mercatus Center.
The views expressed here are the authors' own, and do not necessarily reflect those of any employers or affiliations.
Keywords: CDC, public health, communicable disease, pandemic preparedness, public health policy
JEL Classification: I18, L22, L24, L25, L32, L38
Suggested Citation: Suggested Citation
Phillip H. Phan
Johns Hopkins University - Carey Business School ( email )
100 International Drive
Baltimore, MD 21202
United States