‘Transformation’ Project Underway at CDC

The CDC has launched a new “enterprise transformation project” called CDC Voyager that’s left employees wondering exactly what it will mean for the agency’s future.

Sean Slovenski, CDC’s principal deputy director and chief operating officer, announced the project in an email late last week, after new director Erica Schwartz, MD, MPH, was sworn in.

“The CDC Voyager effort is aimed at charting the course for the future of our agency,” Slovenski’s email stated.

The announcement came just a few days after Slovenski emailed staff that Nina Witkofsky, who was previously deputy director of public affairs, would become the agency’s “chief transformation officer.” Her role includes aiding Slovenski “in the execution of the CDC enterprise transformation project.”

In follow-up notes about the Voyager project emailed to some staff this week, center leaders said the general idea is for CDC to focus on emergency public health responses and infectious disease, which “gives some credibility to the original goal of creating two separate agencies out of the CDC, a MAHA [Make America Healthy Again]-oriented agency and an agency focused solely on infectious diseases.”

Those notes also touch on changes to the CDC’s role internationally, describing potential fee-for-service agreements managed by the State Department. If a country decided not to enter into an agreement with the State Department, they wouldn’t get support from CDC, the notes stated.

The notes also acknowledge that “a lot of this is pie-in-the-sky thinking that most likely won’t be implemented, given the need to secure funding/approval by Congress.”

Slovenski said in his email last week that the Voyager project “starts with listening,” noting that over the past few weeks, he and Jennifer Shuford, MD, MPH, CDC’s deputy director and chief medical officer, have been holding “coffee chats” with CDC employees, along with virtual sessions and interviews with leaders of the agency’s centers, institutes, and offices.

During an “all hands” meeting with Schwartz last week, the coffee chats were mentioned several times, with leadership acknowledging how helpful they were for educating them about the extent of work that CDC does.

“Now we need to think hard about what CDC should prioritize and could become,” Slovenski wrote in his email.

Leadership will be deciding “what CDC should prioritize” and will be holding more listening sessions through December, Slovenski wrote, promising “regular updates.”

They will also be pursuing “immediate improvements” that “can simplify processes, reduce administrative burden, and remove barriers to advancing mission-critical work,” according to his email.

During the all-hands meeting, Schwartz said she, too, would be engaging with teams across the CDC.

“Together, the three of us will be continuing that work, listening, learning, and making sure we hear directly from all of you,” Schwartz said. “We want to hear three things: What must CDC protect? What is preventing you from doing your best work, and what must we improve most urgently to fulfill our core mission?”

“This will not be a listening exercise that disappears into a report that no one will ever see,” Schwartz said. “I will come back to you with what I’ve heard, what we can address immediately, what will take longer, and where choices remain.”

In a question-and-answer session during that meeting, CDC employees raised many concerns, particularly about burnout from a heavier workload due to staff reductions, fears of retribution for speaking out, and concerns about not being prepared for the next big pandemic.

Schwartz acknowledged staff burnout and exhaustion, and reassured them that she would be their advocate.

“I’m week 1 of being here, and now I can certainly be able to advocate for the CDC,” she said, adding that she has been “meeting with S1” — a reference to HHS Secretary Robert F. Kennedy Jr.

“We have a presence there,” she said, referring to HHS headquarters in Washington, D.C. “I will have a presence at the table.”

CDC employees told MedPage Today they were concerned that Schwartz may be spending more time in D.C. than at agency headquarters in Atlanta.

They’re also unsure if the Voyager project means more cuts will be forthcoming.

A MedPage Today request for comment to HHS asking about Schwartz’s time in D.C. versus Atlanta, along with the Voyager project and whether it will mean further reductions in staff, went unreturned as of press time.

Debra Houry, MD, MPH, former deputy director and chief medical officer of the CDC, told MedPage Today in an email that staff have appreciated meeting with leadership. However, they have yet to see meaningful changes, such as “bringing back those on administrative leave.”

At the same time, issues such as President Donald Trump’s executive order on childhood vaccines and the CDC’s edited website on autism and vaccines “are not being publicly addressed,” Houry said.

“Staff hopes this new team can advocate for the real needs of CDC and that the secretary will listen,” she added, “and if things can’t get fixed, the agency won’t be able to staff outbreaks and other programs.”