CDC vows a revamp after backlash to pandemic response

Presented by Kaiser Permanente

With help from David Lim, Alice Miranda Ollstein, Katherine Foley and Daniel Lippman

WELCOME TO THURSDAY PULSE — G’morning, everyone. It’s Megan, your friendly health care lobbying reporter. Buckle up and grab your coffee — it may be August recess, but I’ll never stop never stopping.

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Driving the Day

INSIDE THE CDC OVERHAUL — The Centers for Disease Control and Prevention is undergoing an overhaul following criticism of how it handled the coronavirus pandemic and, more recently, a growing monkeypox outbreak, reports your Pulse co-author, Krista.

Federal regulators conducted reviews of the agency and determined that the “traditional scientific and communication processes were not adequate to effectively respond to a crisis the size and scope of the COVID-19 pandemic,” according to an agency statement.

As a result, CDC Director Rochelle Walensky wants to “transform” the agency and its work culture by improving how the agency shares information, develops public health guidance and communicates with the American public. The CDC didn’t provide a timeline for the revamp.

So, what’s happening inside the CDC? Here are some highlights:

Walensky appointed HHS Deputy Secretary Mary Wakefield to oversee a team charged with ensuring the changes are made. Wakefield is also tasked with setting up a new executive council that will “determine agency priorities, track progress and align budget decisions, with a bias toward public health impact.”

  • An equity office will be established to improve the agency’s diversity across the organization, from hiring to policy.
  • The CDC website will be revamped and streamlined to simplify its public health guidance.
  • The agency will give staff incentives to gear their data and research toward public health policy action instead of scientific publications. In addition, measures to speed up the publication of data and research findings are being considered.
  • Additional staff will be trained to quickly respond to public health emergencies. Emergency staffing will be set up to ensure there are no personnel gaps during a crisis.

Eye on the FDA

SCOOP: FDA TOBACCO OFFICE FACES INDEPENDENT REVIEW — The CDC isn’t the only federal regulator taking a cold, hard look in the mirror: Food and Drug Administration Commissioner Robert Califf called on the Reagan-Udall Foundation to review two offices within the agency.

The nonprofit foundation, an independent body created by Congress to advance modernization of the FDA, has tapped a duo of former agency officials to conduct the evaluations. Katherine has the new details about Lauren Silvis being selected to lead the review of the FDA’s tobacco office.

Silvis, who served as chief of staff to then-FDA Commissioner Scott Gottlieb, will focus on modernizing the structure to streamline the regulatory and compliance processes there. Gottlieb has credited her with, among other things, having helped the agency “advance major efforts to reduce death and disease from tobacco” during her time as chief of staff.

The Biden administration in June ordered Juul to pull its products from the market, but the decision has been temporarily suspended, pending additional review.

Meanwhile, Jane Henney, a Clinton-era FDA commissioner, is heading up a review of the FDA’s food safety program — a particularly important role following the intense blowback the agency received for its handling of the baby formula crisis that stemmed from a product recall and led to a shortage in formula on store shelves.

Abortion

FIRST IN PULSE: KANSAS DEM WANTS TO BUILD ON ABORTION RIGHTS WIN — Kansas’ sole Democratic representative in Congress, Rep. Sharice Davids, is running digital ads highlighting her opponent Amanda Adkins’ anti-abortion record as the state launches a recount of the overwhelming primary vote in favor of abortion rights earlier this month.

Our colleague Alice snagged a first look at the ad, which targets the Kansas City area.

“Our friends and neighbors rejected her extremist politics,” the voiceover says. “Now we can stop Amanda Adkins from bringing her anti-choice agenda to Congress.”

On Aug. 2, Kansas voters cast their ballots on the issue, and 59 percent rejected the amendment that would have allowed state lawmakers to ban abortion, bolstering arguments that reproductive rights are a winning issue for Democrats, even in red and purple states.

In the wake of the Supreme Court decision overturning Roe v. Wade, Democrats have made abortion rights a key campaign issue heading into the November midterms, as polling shows that most Americans disapproved of the ruling.

Davids is defending her seat in a swing district she flipped in 2018 — and facing Adkins as a challenger for the second time. In the 2020 election, she defeated Adkins by 10 percentage points.

On the Hill

DRAMA NOT OVER FOR DRUGMAKERS — Although the Campaign for Sustainable Rx Pricing, also known as CSRxP, scored a victory in its battle with drugmakers with the passage of the Inflation Reduction Act — the group isn’t putting down the gloves just yet.

“Big Pharma’s veneer of invincibility in Washington is gone,” Jon Conradi, a spokesperson for the group, told me. CSRxP’s membership consists mostly of insurers and hospitals.

There’s “a tremendous opportunity,” he said, to push other legislation targeting the pharmaceutical industry, including tapping bills that have moved through the Senate Judiciary Committee.

“We will also be ready to oppose any counter-offensive from Big Pharma targeting the implementation of drug pricing solutions or escalating their repeatedly debunked blame game targeting others in the supply chain,” Conradi said.

Before the sweeping domestic bill passed through Congress, Steve Ubl — who leads the drugmakers’ top industry group — told me the organization planned to fight back if it became law, noting that “few associations have all the tools of modern political advocacy at their disposal in the way that PhRMA does.”

After President Biden signed the bill, Ubl said in a statement that the new law “doesn’t do nearly enough to address the real affordability problems facing patients at the pharmacy,” a thinly veiled dig at pharmaceutical middlemen known as pharmacy benefit managers.

Coronavirus

HHS EXTENDS PUBLIC HEALTH EMERGENCY — The Biden administration — which has pledged to give a 60-day warning before lifting the Covid-19 public health emergency declaration — has yet to contact state and local public health officials ahead of the Aug. 15 notification deadline, David reports. That almost certainly ensures the PHE will continue for another 90 days, pushing it beyond the November elections.

“The COVID-19 Public Health Emergency remains in effect and as HHS committed to earlier, we will provide a 60-day notice to states before any possible termination or expiration,” an HHS spokesperson told David in an email.

Names in the News

Ilse Zuniga is now national press secretary for public health at HHS. She most recently served as press secretary for principal engagement at the agency.

What We're Reading

Health workers are taking the lessons they’ve learned from the Covid-19 pandemic and applying them to dealing with overdoses, gun violence and sexual health, Kaiser Health News reports.

In a post-Roe world, the routine pregnancy tests that occur before surgery are becoming fraught, according to STAT.