CDC director is leaving with a mixed legacy

[January 12, 2009]  ATLANTA, Ga. (AP) -- The woman who led the nation's top public health agency for more than six years is leaving the post with a mixed legacy.

Dr. Julie Gerberding has been praised for strides against bioterrorism and maintenance of the CDC's high standing with the public, but also criticized for hewing closely to Bush administration politics and wrecking morale.

No permanent replacement has been named for Gerberding, who resigned as director of the Atlanta-based U.S. Centers for Disease Control and Prevention. But public health experts have been raising a number of names as they speculate about a possible successor.

Gerberding's departure was revealed in a Friday night e-mail to employees of the U.S. Department of Health and Human Services, the umbrella agency over CDC.

The e-mail said she will be replaced on an interim basis by a deputy as of Jan. 20, the day President-elect Barack Obama is inaugurated.

Although an HHS housecleaning has been expected with the new administration, Gerberding's fate had been somewhat unclear. The first woman to head the agency, Gerberding led the CDC through a post-Sept. 11 world of bioterrorist fears and was considered an effective communicator with legislators and the public. Colleagues said she quietly had held out hope she would be allowed to stay on.

Speculation that she might remain was fueled by Obama's selection of Tom Daschle as HHS secretary. Daschle, the former Senate Democratic leader, is from South Dakota -- like Gerberding. But Friday's e-mail confirms she will indeed be leaving office, a CDC spokesman said.

"As part of the transition process, the administration requested resignation letters from a number of senior-level officials, including Dr. Julie Gerberding. This week, the administration accepted Dr. Gerberding's resignation, effective Jan. 20," CDC spokesman Glen Nowak said in a prepared statement.

Nowak said Gerberding was traveling in Africa on CDC business and unavailable for comment.

The CDC investigates disease outbreaks, researches the cause and prevalence of health problems, and promotes illness prevention efforts. In a 2007 Harris Poll of U.S. adults, the CDC was rated as the government agency that does the best job.

Gerberding is head of the CDC and its sister agency, the Agency for Toxic Substances and Disease Registry. The two have a budget of about $8.8 billion and more than 14,000 full-time, part-time and contract employees. Gerberding receives a total compensation of $202,200.

William Gimson, the CDC's chief operating officer, will step in as interim director as of Jan. 20.

Who will be appointed permanent successor is a matter of public speculation. In interviews with The Associated Press, several public health experts ventured names they saw as likely or sensible choices, including Dr. Thomas Frieden, commissioner of the New York City Department of Health and Mental Hygiene; Dr. Helene Gayle, a former CDC administrator who is now chief executive officer of CARE International; Dr. Margaret Hamburg, a former HHS official now with the Global Health and Security Initiative; and Dr. James Marks, a former CDC administrator now at the Robert Wood Johnson Foundation.

But Daschle has made no announcement. Two former CDC officials -- Dr. Jeffrey Koplan and Dr. Jose Cordero -- have been helping the Obama transition team, but both declined comment on who is under consideration.

Gerberding, 53, was named CDC director in July 2002. She was a relative newcomer to the agency; she had been an infectious diseases specialist at the University of California at San Francisco, and had joined the CDC in 1998 to head an agency patient safety initiative.

She rose to prominence in the fall of late 2001, when she emerged as a leading spokeswoman for the agency during the anthrax crisis in which letters containing a deadly anthrax powder were sent to some politicians and journalists and perhaps others. Five people died in a wave of attacks that panicked a nation already shaken by the Sept. 11, 2001, terrorist attacks.

Koplan was the CDC director at the time. Appointed by President Bill Clinton, Koplan had a prickly relationship with Bush administration officials. He resigned in March 2002.

Gerberding was selected by Tommy Thompson, Bush's first U.S. Secretary of Health and Human Services, who was impressed by her performance during the anthrax crisis. She entered office pledging to work closely with the Bush administration.

She was the agency's first female director -- a status highlighted in a profile in Vogue magazine that featured a full-page color photograph of her in a gray Chanel suit and white Marc Jacobs high-heeled shoes. The white streak in her hair and her "JLG" signatures on memos were well-known details of her distinctiveness.

Gerberding was a highly visible spokeswoman for the government on public health matters, eclipsing officials such as the surgeon general and the director of the National Institutes of Health in visibility. That was due in part to the scary, urgent nature of topics her agency dealt with, including SARS, food poisoning outbreaks and the threat of a deadly new type of pandemic flu.

But her tenure also proved controversial:

• She instituted a large, morale-damaging reorganization of the agency that triggered an exodus of admired agency scientists. Gerberding said the changes made the CDC stronger. But in 2005, five previous CDC directors wrote Gerberding a joint letter expressing their concern about what was happening to the agency.

• A 2004 medical journal article co-authored by Gerberding said obesity was about to overtake smoking as the No. 1 cause of death in the United States, but CDC officials later reported they had overstated the increase in obesity-related deaths by about 35,000. The mistake was blamed on a computer software error.

• After Hurricane Katrina in 2005, the agency was criticized for being slow to respond to survivors' complaints about formaldehyde fumes in trailers that had been provided by the government.

• She was criticized at times for going along with Bush administration political positions at the sacrifice of science. In 2007, she was knocked for going along with White House editing of her Senate testimony on the effects of climate change on health, which involved deletion of key portions citing diseases that could flourish in a warmer climate.

[Associated Press; By MIKE STOBBE]

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