CDC's outgoing principal deputy director Dr. Anne Schuchat: What I learned over 33 years at the agency


Anne Schuchat, MD, principal deputy director of the CDC, is retiring at the end of June. In an op-ed published June 10 by The New York Times, Dr. Schuchat shared what she learned during her 33 years at the agency and what she hopes the future will hold.

Below are the highlights: 

Public service is difficult. The COVID-19 pandemic has exhausted, saddened and sometimes sidelined many public health officials. While the pandemic isn't the first time the U.S. public health system had to surge beyond capacity, it has been the collision of the worst pandemic in a century with a system suffering from years of underinvestment. Public health departments have lost an estimated 66,000 jobs since around 2008, according to a National Academy of Medicine report cited by Dr. Schuchat.

"With prior responses, the public health front line has been the little engine that could," Dr. Schuchat wrote. State and local health departments would absorb the initial shock of each crisis until emergency funding came, and then watch resources ebb as the crisis abated. In the past few decades, public health's core capacities gradually weakened while biomedical research and development accelerated. With COVID-19, public health was the little engine that couldn't.

Dr. Schuchat hopes the pandemic has made it clear that when we don't invest in public health, everyone is vulnerable.

The U.S. public health system needs major upgrades. Data systems and lab capacities must be modernized. Public health information and response efforts must be better integrated with clinical, commercial and academic sectors. The U.S. needs a renewed and expanded public health workforce that reflects advanced skills and diversity.

The CDC and public health departments are now receiving critical financial resources on an emergency basis. But these investments must be sustained. The COVID-19 pandemic will not be the last major threat our nation will face.

Public service is deeply meaningful. In her first years at the CDC, Dr. Schuchat studied group B strep, an infection that harms newborns. She spearheaded CDC efforts, and, in 1996, the agency, along with The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, issued the first consensus guidelines that made prevention of group B strep a standard of care in the U.S. The new guidance requiring prenatal screening has prevented more than 100,000 life-threatening infections. Public health efforts, not a new biomedical discovery, protected most from the condition. 

Public service is also joyful. Public health successes usually take place out of the spotlight, which for most is just fine; victory often means preventing something bad from happening. If no one knows about it, that is often an indication of success. 

Amid the disruptions and threats of the pandemic, Dr. Schuchat hopes this is a moment "when a new generation is called to action, to experience the difficulty and meaning and joy of public service. Our world needs you."


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