The country's front line for tracking disease and protecting public health.
CDC tracks disease, runs the country's public health surveillance, and produces the guidance that state and local health departments, clinicians, and the public rely on.
CDC depends on state cooperation with no federal framework, so the country learns about threats at the speed of the slowest state. Its advisory committees carry great weight but thin legal protection, and its evidence and policy work are hard to tell apart from outside. None of this is attributable to a single administration.
Modernize federal-state surveillance through standards CDC sets and ties to funding, a legal framework for reporting, and payment-linked reporting through CMS.
Codify protections for ACIP and HICPAC to match the weight their recommendations carry, with continuity rules and minimum methodological standards.
Make every major CDC guidance document show what the evidence says and who decided what to do about it.
Require CDC to publish the plan for designated studies before the analysis is run, and to publish the analysis code afterward.