The Centers for Disease Control and Prevention CDC

The CDC began on July 1, 1946, as the Communicable Disease Center, a small Atlanta office descended from the wartime program to keep malaria away from Southern military bases. Atlanta was chosen because malaria was a Southern problem, and Emory University sold the agency its land for ten dollars. From mosquitoes it expanded to every infectious disease, then to chronic disease, injury, environmental hazards, and workplace health. Its Epidemic Intelligence Service, founded in 1951 to detect biological attacks, became the disease detectives who traced Legionnaires' disease, toxic shock syndrome, and the first cases of AIDS.

The agency's core work is surveillance: collecting reports from state and local health departments, hospitals, and laboratories to see outbreaks before they spread, and sending teams to investigate. It publishes the Morbidity and Mortality Weekly Report, the bulletin through which the country learns of new threats. It sets the childhood and adult immunization schedules on the advice of an expert committee and buys about half the nation's childhood vaccines through the Vaccines for Children program. It runs the Strategic National Stockpile with the rest of HHS, operates laboratories that handle the world's most dangerous pathogens, and funds the state and local health departments that do most frontline public health work.

The CDC has no police powers to speak of. It cannot order a quarantine within a state, close a business, or require a vaccine. Those powers belong to states and localities. Its influence rests on money, expertise, and the trust that its guidance commands, which is why its credibility is treated as a national asset and why damage to it matters. About 13,000 employees, two thirds of them in Atlanta, work on a budget near 9 billion dollars, most of which passes through to states. The Director was made a Senate-confirmed position in 2023.

The pandemic exposed the agency's weaknesses, from a failed first test kit to shifting guidance, and left its reputation lower than at any point in its history among parts of the public. Reform efforts followed. In 2025 the agency lost roughly a quarter of its staff, its confirmed Director was dismissed within weeks of taking office, the vaccine advisory committee was replaced wholesale, and several of its senior scientists resigned in protest. Supporters of the changes said the agency had become bloated and ideological. Its defenders said the country was dismantling its outbreak defenses in peacetime.