October 20, 2023
Senator Bill Cassidy, M.D.
Ranking Member, Senate Committee on Health, Education, Labor, and Pensions
455 Dirksen Senate Office Building
Washington, DC 20510
RE: HELP Committee RFI seeking input on opportunities to continue modernizing the U.S. Centers for Disease Control and Prevention
Dear Ranking Member Cassidy,
On behalf of the CEO Members of Business Roundtable, we thank the Committee on Health, Education, Labor, and Pensions for the opportunity to comment on proposals to continue modernizing the U.S. Centers for Disease Control and Prevention (CDC). Business Roundtable is an association of more than 200 chief executive officers (CEOs) of America’s leading companies, representing every sector of the U.S. economy. Business Roundtable CEOs lead U.S.-based companies that support one in four American jobs and almost a quarter of U.S. GDP.
We commend you and your colleagues for working to improve communication and transparency between the CDC and the public and agree that there are lessons to be learned from the CDC’s response to the COVID-19 pandemic.
From the start of the COVID-19 outbreak, Business Roundtable companies closely monitored data and guidance from the CDC. Companies communicated often, and to the best of their ability, with their employees to ensure their workforces remained safe. At the same time, our companies in the biopharmaceutical space invested heavily in research and development and helped bring 3 vaccines, 7 therapeutics and 1 antiviral against COVID-19 to the market in less than a year, when typical vaccine development takes 5 to 10 years or more. When these vaccines were made available to the public, Business Roundtable companies led the efforts to encourage their employees to get vaccinated against COVID-19.
We appreciate your efforts to identify actions that will enhance communication between the CDC and the American people and improve trust in our public health institutions. The COVID-19 pandemic exacted a devastating toll on the life, health, and economic circumstances of Americans, and also eroded the trust in public health institutions that is vital to a successful public health response. Despite the best efforts of so many on the federal, state, and local levels, and in the private sector, and the resilience shown by our fellow citizens and communities, the COVID-19 pandemic has left a tenuous relationship between the CDC and the American public.
Our member companies share the Committee’s interest in looking toward the future for a more open, collaborative, and responsive CDC. In pursuit of this goal, we provide the following comments in response to this RFI:
Fostering Innovation and Collaboration
What steps can CDC take to identify more, and engage in, external partnerships? This includes partnerships with the interagency, academia, and the private sector.
Business Roundtable member companies demonstrated firsthand the importance of collaboration between public health authorities and the private sector during the COVID-19 pandemic. Public-private partnerships were responsible for rapidly developing, testing, manufacturing and distributing many of the COVID-19 vaccines, tests, therapeutics, and other vital response materials such as personal protective equipment (PPE). Our member companies touched all aspects of the COVID-19 response, from manufacturing vaccines, distributing them through the supply chain, administering vaccines and tests at pharmacies and retailers, leading corporate vaccination initiatives, and making health and safety improvements in the workplace.
Given our daily reach to hundreds of millions of Americans, the business community should be considered an essential partner to CDC and be given real-time, clear, and actionable information to work with in future public health emergencies. Congress should consider ways to formalize engagement between CDC and private sector partners to seek advice and share perspectives. Congress should also encourage CDC to see such partnerships as an effective vehicle for the apolitical distribution of public health system data.
Making Data Work for Everyone
CDC’s Center for Forecasting and Outbreak Analytics intends to provide information to support timely decision-making and action. How can this approach be applied across CDC, and how can CDC’s data better inform the actions of other federal, state, and local decision-makers?
To better understand and respond to future pandemics, public health data systems must be modernized to provide more accurate and timely information to aid policymakers in decision-making on both the front and back ends of any future public health emergency. Greater coordination across agencies and transparency to the public around public health data is critical for future pandemic preparedness.
In addition to collecting and sharing more timely data that is focused on the most meaningful metrics, Business Roundtable also recognizes that how data is communicated is also essential.
In the future, the federal government needs to do a better job of reporting evidence in a clear and helpful manner to avoid any perception of improper political bias. Business Roundtable encourages the Committee to consider how the CDC Center for Forecasting and Outbreak Analytics could be expanded to help inform and prepare the private sector for future potential outbreaks. It will be just as important that the information the Center reports out is timely and accurate as it is that the communication is clear and understandable. The spread of disease and mitigation measures, such as widespread closures, during the COVID pandemic took a major toll on businesses. Future threats identified by the Center are in most cases not going to be nearly as significant as what we faced during COVID. It is critical that messages about new outbreaks not unnecessarily scare or confuse the public and that businesses understand how to appropriately respond.
Improving Upon What Works Well
Which aspects of CDC’s Moving Forward Initiative do you think are progressing well, and which could be improved? What role, if any, do you think Congress can play in helping to improve this work?
- Translate Science into Practical, Easy to Understand Policy: While the private sector engages with the public health system at all levels, businesses need simple, easy-to-understand information that they can translate into policies to communicate to employees (e.g., when to stay home after disease exposures, when it is safe to return to work, how to make risk-based decisions, etc.). CDC should work to ensure that the rationale for its guidance and policies is clear to lay people unfamiliar with epidemiology, immunology and other relevant scientific fields of study. Without simple, practical guidance, CDC will continue to struggle to forge trust with the public.
- Prioritize Public Health Communications: While Business Roundtable recognizes that CDC does important, lifesaving work every day, we encourage the CDC to put additional effort into clear communication with the public. CDC should work to consistently make the public aware of the work the centers are doing to improve public health and prepare for future threats.
- Promote Results-based Partnerships: The public health system is only effective if the private sector is an active partner in the development and deployment of public policy solutions. The COVID-19 pandemic showed that in some areas, the federal government failed to engage the private sector quickly and effectively in a coordinated response. As a result, many of the early decisions made lacked input from the business community, including on the economic impacts of proposed public health policies. The private sector should be an ongoing partner to the government in pandemic preparedness going forward. To accomplish this, we suggest the following:
- The federal government must have a clearly identified leadership structure to manage a “whole of government” pandemic response.
- Private sector stakeholders must be included in pandemic preparedness and response plans and exercises on an ongoing basis.
- The federal government should continuously update and regularly exercise data-driven, evidence-based pandemic response plans in concert with state and local governments, health care providers, and other key stakeholders.
- Pandemic preparedness and response plans should address both the public health and economic dimensions of the crisis.
Thank you for the opportunity to provide feedback and lessons learned toward a common goal of improving CDC operations and enhancing public trust. Business Roundtable stands ready to work with members of the HELP Committee to modernize the CDC and strengthen the U.S. public health system of the future through transparency and clarity.
Vice President, Health and Retirement Committee
1000 Maine Avenue, SW
Washington, DC 20024
Phone: (202) 872-1260