Centers for Disease Control and Prevention

Based on Wikipedia: Centers for Disease Control and Prevention

In 1947, the employees of a small government health agency pooled their own money to buy fifteen acres of land in Atlanta, Georgia. The purchase price was ten dollars. The real benefactor behind this token transaction was Robert Woodruff, chairman of Coca-Cola, who had a personal vendetta against malaria—the disease kept ruining his hunting trips in the South. That modest plot of land remains the headquarters of what has become one of the most powerful public health institutions on Earth: the Centers for Disease Control and Prevention, universally known as the CDC.

The story of the CDC is not a straightforward tale of scientific triumph. It's a story of mission creep and moral failure, of zombie apocalypses used as public relations stunts and gun research shut down by political pressure, of lifesaving vaccines and botched pandemic responses. It's the story of an agency that inherited one of the most shameful experiments in American medical history and later admitted to shipping biological weapons materials to Saddam Hussein's Iraq.

To understand American public health—its possibilities and its failures—you have to understand the CDC.

Born from Mosquito Control

The CDC traces its lineage to World War II, when the American military had a malaria problem. Troops training in the southeastern United States were getting sick in alarming numbers, and the military established programs to control the mosquitoes that spread the disease. When the war ended in 1946, this operation transformed into a civilian agency called the Communicable Disease Center.

Atlanta was chosen as the location for a simple reason: malaria was still endemic in the American South. The disease that we now associate primarily with tropical Africa and Southeast Asia was, within living memory, a routine killer of Americans in states like Georgia, Alabama, and Mississippi.

The early CDC was not primarily a medical organization. Of its 369 original employees, most were entomologists—scientists who study insects—and engineers. Their job was to kill mosquitoes. In those first years, CDC workers sprayed more than six and a half million homes, mostly with DDT, the insecticide that would later become infamous for its environmental devastation but at the time seemed like a miracle chemical.

Only seven medical officers worked at the agency when it opened. The budget was about one million dollars. The offices occupied a single floor of a building on Peachtree Street.

The Tuskegee Inheritance

When the CDC was formed, it inherited ongoing programs from its predecessor organization, the United States Public Health Service. One of these was the Tuskegee syphilis experiment, and this inheritance would become one of the darkest chapters in American medical history.

The study had begun in 1932 in Macon County, Alabama, where Public Health Service researchers recruited approximately 600 Black men, about 400 of whom had syphilis. The researchers told the men they were being treated for "bad blood," a vague term that could mean almost anything. In reality, the researchers had no intention of treating anyone. They wanted to observe the natural progression of untreated syphilis in human subjects.

The men were never told they had syphilis. They were never given informed consent. They were never offered treatment, even after penicillin became the standard cure for syphilis in the 1940s. The CDC continued this study for decades.

The experiment didn't end until 1972, when a whistleblower leaked information to the press. By then, participants had died of the disease, had infected wives and partners, and had passed congenital syphilis to children. The Tuskegee study became a defining example of medical racism and research ethics violations, and its legacy continues to affect African American trust in public health institutions today.

Disease Detectives and Cold War Anxieties

The Korean War brought a different kind of fear to American public health officials. In 1951, the CDC's chief epidemiologist, Alexander Langmuir, warned that the enemy might use biological weapons against American troops or even the American homeland. His solution was to create a rapid-response team of what would come to be called "disease detectives."

The Epidemic Intelligence Service, or EIS, began as a two-year training program for young doctors and scientists. The idea was straightforward: identify disease outbreaks quickly, determine their cause, and stop them before they spread. Whether the outbreak came from a natural source or an enemy attack, the response would be similar.

The EIS became one of the CDC's most influential innovations. These disease detectives have investigated outbreaks on every continent, from Ebola in Africa to mysterious respiratory illnesses in hotel air conditioning systems. The program has trained thousands of epidemiologists, and its model has been exported worldwide.

In 1980, the CDC launched Field Epidemiology Training Programs in other countries, starting with Thailand. The goal was to help nations build their own disease surveillance and response capabilities. More than 18,000 people have now trained through these programs in over 80 countries. When a new disease emerges anywhere in the world, there's a reasonable chance that someone who learned their craft through a CDC-influenced program will be among the first responders.

The Expanding Mission

The CDC began with malaria. It did not stay there.

In 1957, the agency absorbed the Public Health Service's venereal disease division, adding sexually transmitted infections to its portfolio. Tuberculosis control followed in 1960. An immunization program launched in 1963.

The name changed to reflect the expanding mission. It became the National Communicable Disease Center in 1967, then simply the Center for Disease Control in 1970. Note the singular "Center"—that would change.

By the 1980s, the agency had grown into a constellation of specialized units. The Center for Infectious Diseases handled traditional outbreak response. The Center for Chronic Disease Prevention and Health Promotion addressed conditions like heart disease and diabetes—illnesses that aren't caught from other people but kill far more Americans than any infection. The Center for Environmental Health and Injury Control tackled everything from toxic waste to car accidents.

In 1980, Congress made the name plural: Centers for Disease Control. And in 1992, they added "and Prevention" to emphasize that stopping diseases before they start was as important as controlling them after they spread. But Congress made a curious decision about the acronym. Despite the new name—Centers for Disease Control and Prevention—the agency would keep calling itself the CDC rather than switching to CDCP. The old initials had too much brand recognition to abandon.

The Gun Research Shutdown

In the early 1990s, CDC researchers turned their attention to a different kind of public health threat: firearms.

Mark Rosenberg and colleagues at the agency's National Center for Injury Prevention and Control began studying gun deaths the same way the CDC studied any other cause of death and injury. They collected data. They looked for patterns. They identified risk factors.

Their first major study, published in 1993 in the New England Journal of Medicine, found that having a gun in the home increased the risk of firearm homicide by 2.7 times and the risk of suicide by five times. The researchers approached gun violence as a public health problem—not a political issue, but a question of what factors made death more or less likely.

The National Rifle Association saw this research as an attack and launched a campaign to defund the injury center. Pro-gun physicians' groups joined the effort. Politicians listened.

In 1996, Representative Jay Dickey of Arkansas attached an amendment to the CDC's appropriations bill. The Dickey Amendment stated that none of the CDC's injury prevention funding could be used to "advocate or promote gun control." The amendment didn't technically ban research—it banned advocacy. But the practical effect was chilling. Congress simultaneously cut the CDC's budget by the exact amount the agency had been spending on gun research and redirected those funds to traumatic brain injury studies.

The message was clear. CDC leadership got cautious. For more than two decades, the agency largely avoided firearms research, even though guns kill roughly 40,000 Americans annually. Only recently has there been modest movement to resume such studies, and the research infrastructure that was dismantled in the 1990s has never been rebuilt.

Smallpox, Anthrax, and Biodefense

The CDC maintains some of the most dangerous facilities on Earth.

Biosafety Level 4 laboratories—the highest security classification—are designed to handle pathogens for which no treatment or vaccine exists. There are only a handful of such facilities worldwide. The CDC operates some of them.

One of the CDC's unique responsibilities involves smallpox. This disease killed hundreds of millions of people throughout human history before a global vaccination campaign eradicated it in 1980. The virus now exists in only two official locations: the CDC in Atlanta and the State Research Center of Virology and Biotechnology in Russia. These samples are kept for research purposes, though there has been periodic debate about whether they should be destroyed entirely.

The security around these facilities is not perfect. In 2014, CDC workers discovered misplaced smallpox samples that shouldn't have been where they were found. The same year, lab workers were potentially exposed to anthrax due to procedural failures. These incidents raised serious questions about safety protocols at an agency responsible for containing the world's most dangerous pathogens.

Zombies as Public Health Messaging

In May 2011, the CDC's official blog published instructions for surviving a zombie apocalypse.

This was not a joke, exactly. It was a communications experiment.

David Daigle, the agency's associate director for communications in the preparedness division, had grown frustrated with the annual hurricane-awareness campaign. "We say pretty much the same things every year, in the same way," he observed, "and I just wonder how many people are paying attention."

A social media staffer mentioned that zombie references had spiked on Twitter during discussions of the Fukushima nuclear disaster in Japan. Radiation and zombies—there was clearly an audience that engaged with emergency preparedness through the lens of popular culture rather than earnest government warnings.

The CDC team created a zombie preparedness campaign. The logic was simple: the supplies you'd need for a zombie apocalypse—water, food, medications, flashlights, important documents—are exactly the same supplies you'd need for a hurricane, earthquake, or pandemic. "If you're prepared for a zombie apocalypse," Daigle said, "you're prepared for pretty much anything."

The campaign went viral. The CDC followed up with a YouTube video contest and a zombie-themed graphic novel. Teachers received educational materials featuring the undead. It was perhaps the most successful public engagement campaign in the agency's history—and a reminder that government health communication often fails not because people don't care about their health, but because official messages are boring.

What the CDC Sent to Iraq

In May 1994, the CDC acknowledged something that complicated any narrative of the agency as purely a force for public health good.

Between 1984 and 1989, the CDC had sent samples of dangerous pathogens to the Iraqi government. These included Botulinum toxin, which causes botulism. West Nile virus. Yersinia pestis, the bacterium that causes plague. Dengue fever virus.

At the time, Iraq was led by Saddam Hussein. The Iran-Iraq War was ongoing, and the United States was tilting toward Iraq as a counterweight to Iran. The samples were ostensibly sent for research purposes.

Iraq later used biological agents in its weapons program. The same pathogens the CDC had shipped appeared in Iraqi biological warfare development. The agency had provided materials that a hostile government repurposed for weapons of mass destruction.

This episode is rarely mentioned in discussions of the CDC's legacy, but it illustrates an uncomfortable truth: the infrastructure of public health and the infrastructure of biological warfare are often the same infrastructure. The same laboratories that develop vaccines can develop weapons. The same expertise that contains outbreaks can create them.

The COVID-19 Failure

The coronavirus pandemic that began in 2020 should have been the CDC's moment of vindication—proof that decades of preparation and expertise had built an institution capable of protecting Americans from exactly this kind of threat.

Instead, it became a case study in institutional failure.

The first confirmed case of COVID-19 in the United States was identified on January 20, 2020. The country urgently needed widespread testing to understand where the virus was spreading. The CDC developed a test.

The test didn't work.

Kits shipped to laboratories across the country gave inconclusive or inaccurate results. Later investigations found that the CDC had violated its own protocols during test development and that the tests may have been contaminated during processing at CDC facilities. An internal review revealed that the agency knew the first batch of tests had a 33 percent chance of being wrong—and released them anyway.

It took nearly three weeks to fix the problem. During those weeks, the virus spread unchecked through American communities, and the country had no way to track it. By the time widespread testing became available in early March, the opportunity for early containment had passed.

The failures continued. In May 2020, The Atlantic reported that the CDC was combining the results of two fundamentally different types of tests—diagnostic tests that detect current infection and antibody tests that reveal past infection—into a single number. This made the country's testing capacity look larger than it actually was and rendered the data nearly meaningless for understanding the state of the pandemic.

In August 2020, the agency issued guidance suggesting that people without symptoms didn't need testing—advice that contradicted the emerging scientific understanding that asymptomatic transmission was a major driver of spread. The guidance, it turned out, had been crafted by political appointees in the White House without sign-off from the agency's own experts.

By 2022, CDC Director Rochelle Walensky publicly acknowledged "some pretty dramatic, pretty public mistakes, from testing to data to communications." An internal review led to a reorganization aimed at making the agency faster and more effective.

The pandemic revealed that the CDC, for all its expertise and resources, was not structured for rapid response to a fast-moving crisis. It was better at studying diseases than at providing real-time guidance during an emergency. Its communication was often confusing or contradictory. Its relationship with political leadership compromised its scientific independence.

Reorganization and Uncertain Future

The CDC that exists today is not the same agency that will exist tomorrow.

As part of a 2025 reorganization of the Department of Health and Human Services, the CDC is planned to be reoriented toward infectious disease programs—a return, in some ways, to its original malaria-fighting mission. The agency is set to absorb the Administration for Strategic Preparedness and Response, which handles emergency medical stockpiles and disaster response. Meanwhile, the National Institute for Occupational Safety and Health, which has been part of the CDC since 1973, is planned to move out to a new administrative home.

These changes reflect ongoing debates about what the CDC should be. Should it focus narrowly on infectious diseases—the germs that spread from person to person and can cause pandemics? Or should it maintain its broader public health mission, addressing chronic diseases, injuries, environmental hazards, and workplace safety?

The narrow view argues for expertise and focus. The broad view argues that health is interconnected—that you can't separate infectious diseases from the poverty, housing conditions, and workplace exposures that make some populations more vulnerable.

The CDC's Atlanta headquarters now sits within the city limits, following a 2018 annexation that was the largest in Atlanta's history in 65 years. The annexation was requested by the CDC and Emory University to enable a transit expansion. The disease-fighting agency that started on one floor of a Peachtree Street building now occupies a campus large enough to warrant its own train station.

The Paradox of Public Health

Public health has a visibility problem. When it works, nothing happens. Diseases don't spread. Outbreaks don't occur. People don't die. The absence of catastrophe is invisible.

The CDC has prevented countless deaths that no one will ever count because the deaths never occurred. The smallpox eradication campaign eliminated a disease that had killed perhaps 300 million people in the twentieth century alone. Vaccination programs have reduced childhood diseases to footnotes in medical textbooks. Food safety surveillance catches contaminated products before they cause mass poisonings.

But when public health fails—when a pandemic spreads, when a test doesn't work, when communication breaks down—the failures are vivid and immediate. People get sick. People die. Someone must be blamed.

The CDC operates in this paradox. Its successes are invisible. Its failures are front-page news. Its budget depends on politicians who gain no credit for diseases that didn't happen but face intense criticism for diseases that did.

Understanding the CDC means understanding this fundamental asymmetry. It means understanding why an agency can be both genuinely lifesaving and genuinely dysfunctional, why it can contain one outbreak brilliantly and botch another catastrophically, why it can be trusted with the last remaining samples of smallpox but not trusted to produce a working diagnostic test.

The CDC is not a single thing. It's a collection of centers and programs and laboratories and people, accumulated over eight decades, shaped by wars and politics and scandals and successes. It began with mosquitoes and ten dollars for land in Georgia. Where it goes from here depends on decisions being made right now about what public health means and who deserves to be protected from disease.

The disease detectives are still out there, investigating outbreaks, tracing contacts, trying to stop the next pandemic before it starts. Whether they'll have the resources and independence to succeed is a question that remains very much open.