The CDC informed personnel in the past two weeks that it was discontinuing its work in 39 out of 49 countries where its Center for Global Health helps prevent, detect and respond to dangerous infectious disease threats, such as Ebola and the Zika virus. The agency said it was forced to make the decision because it doesn't expect any new funding for the programs.
The decision sparked outrage among an array of top health officials and organizations who said Congress and the Trump administration are leaving the nation vulnerable to an outbreak that could affect millions of Americans.
"We can either help other countries stop disease outbreaks abroad or fight them here at home," said Dr. Tom Frieden, director of the CDC from 2009 to 2017. "If funding for global health security isn't found, CDC will have to retreat from the front lines of fighting not terrorism but terrible organisms in 30 countries."
Frieden, who has devoted much of his career to disease prevention, emphasized the potential danger of the move. "Not only would this set back scientific, technical and diplomatic relationships that have taken years to develop, it would significantly increase the chance an epidemic will spread without our knowledge and endanger lives in our country and around the world," he said.
Frieden now serves as president and CEO of the initiative Resolve to Save Lives.
A coalition of health organizations echoed Frieden's sentiment, saying it would be foolish and dangerous to make such drastic cuts.
"As the United States and the world begin to reap the benefits of our investments in better disease preparedness, now is not the time to step back," said a joint letter
from the coalition of four groups, representing more than 200 organizations, to Health and Human Services Secretary Alex Azar. "The ongoing danger that biological threats pose to American health, economic, and national security interests demands dedicated and steady funding for global health security."
The goal of the CDC's Center for Global Health is to stop outbreaks at their source, long before they reach the United States. The organization monitors 30 to 40 outbreaks in other countries every day, and it has trained more than 10,000 disease detectives in more than 70 countries, according to its website
The initiative was begun during Frieden's tenure and funded for five years, ending in October 2019.
Personnel were notified of the cuts in a 40-minute conference call January 18.
Dr. Rebecca Martin
, the Center for Global Health's director, listed a series of successes, including helping Sierra Leone rapidly identify outbreaks and aiding the Democratic Republic of Congo in its fight against Ebola, according to a source familiar with the call.
Martin said work would remain in 10 priority countries: India, Thailand, Vietnam, Jordan, Kenya, Uganda, Liberia, Nigeria, Senegal and Guatemala. In the 39 other countries where programs operate, she said, transition planning to end them was underway, with full departure by October 2020.
If more funding becomes available, she said, the center could enhance operations in five countries: China, the Democratic Republic of Congo, Ethiopia, Indonesia and Sierra Leone.
"We understand and appreciate that this is difficult news, and it has been trying and frustrating for many staff -- both in the field and at headquarters," she said.
During the call, Dr. Nancy Knight
, director of the Center for Global Health's Division of Global Health Protection, elaborated on the magnitude of the cuts, saying they would "cut across the entire Division of Global Health Protection portfolio of programs."
"We estimate approximately an 80% reduction in the staff that are based overseas," Knight said. "This is also going to result in a significant reduction of the staff we have at headquarters."
The CDC said in a statement that it is "currently participating in a deliberative policy process to determine our commitments moving forward" and that it was awaiting the administration's new budget, expected in late February.
On its website, the Division of Global Health Protection describes the importance of its work this way: "We live in a highly mobile and connected world, where the impact of health threats reaches farther and wider than ever. We know that a disease can be transported from an isolated rural village to any major city in as little as 36 hours. An outbreak anywhere is a threat everywhere."