The new director of the Centers for Disease Control and Prevention said she will prioritize a wide range of public health issues, from fighting infectious disease to strengthening early-childhood development, as the federal agency faces potentially substantial budget cuts.
In an interview at the end of her first week on the job, Brenda Fitzgerald said she would make a strong case for public health spending should the agency fall on tough times.
“When there are austere times, the most important factor is that you have to know what your mission is,” Dr. Fitzgerald said. “You make sure what you’re doing is indeed fulfilling that role, because there are certain things that I believe only public health can do,” she said.
The Trump administration has proposed a $1.22 billion, or 17%, cut to the CDC’s budget for fiscal 2018, including reductions in chronic disease prevention and epidemic preparedness.
Many public health experts welcomed Dr. Fitzgerald’s July 7 appointment, because she is a public health advocate and leader. But she has been criticized for a Georgia childhood obesity program that accepted funds from Coca-Cola Co.’s foundation and for offering controversial anti-aging remedies as a practicing obstetrician-gynecologist.
Dr. Fitzgerald, 71 years old, grew up in Middlesboro, Ky., a town in coal-mining country. She “met this cute boy in medical school” at Emory University and has been in Georgia ever since, practicing as an OB-GYN for three decades, raising a daughter and son, and serving state Republican leaders. She was Georgia’s public health commissioner from 2011 until she was named to her CDC post.
A microbiologist works in a lab within the Infectious Disease Laboratory at the Centers for Disease Control and Prevention in 2013. The agency’s new head said fighting infectious disease will be a priority.)Photo: David Goldman/Associated Press
She said she is commuting to her new job from her home in Carrollton, Ga., nearly 60 miles west of Atlanta because “that cute boy I married—he grew up there. He’s not moving.”
She calls herself a “strong advocate for vaccines” and says she supports making reliable contraception available, two issues that have been scrutinized by the new administration.
Rates of premature births can be brought down by spacing births, saving on health-care costs, she said, an approach that generally requires contraception. Caring for a premature infant in the first year, of life costs about 10 times as much as caring for a healthy, full-term baby, making it one of the most expensive health-care needs, and that added costs extend well beyond the first year. “It’s huge,” she said.
She believes decisions about abortion should be made “between a woman and her doctor,” with limitations. “There’s absolutely no case once a child is viable,” she said. But, she added, “I did not do abortions in my practice.”
The CDC collects data on abortions but doesn’t fund them.
Dr. Fitzgerald said that preventing the spread of infectious disease will remain a priority for the agency. “Quite frankly, it’s our responsibility,” she said.
That includes doing more to prevent antibiotic resistance, tracking emerging infections overseas and helping other countries build their infectious-disease-fighting capacities, she said.
Battling the U.S.’s biggest killers will also be a focus for the CDC under her leadership, she said, though she didn’t cite specifics. Fighting opioid addiction—which killed more than 33,000 people in the U.S. in 2015—is a priority for the administration, her spokeswoman said.
She said she also wants to make advances in an area she championed as Georgia’s public health commissioner: children’s early brain development. “If we can change something at the very beginning that is a simple intervention like language development, that’s a phenomenal chance to influence that child’s entire life,” she said.
Dr. Fitzgerald has come under fire for the Georgia SHAPE childhood obesity program, which took $1 million from 2013 to 2015 from the Coca-Cola Foundation to promote physical activity.
She said that the state purposely sought partners from every sector, including large area employers such as Coca-Cola, to join its $57 million program. The program promotes eating fresh fruits and vegetables in addition to physical activity, she said.
“I think if you’re going to solve a big problem, you’ve got to have a public-private partnership,” she said. “What you have to do is start at that place on which there is agreement and work from there.”
As a practicing OB-GYN, Dr. Fitzgerald said she took continuing education courses to become a fellow in anti-aging medicine after getting many questions from menopausal patients. Such therapies include bioidentical hormones, which are identical in molecular structure to the hormones women make in their bodies.
They are often marketed as a safer alternative to traditional hormone replacement therapy, but have skeptics because they haven’t been well studied. The Food and Drug Administration says it doesn’t have evidence that bioidentical hormones are safer or more effective than other hormone products.
“One, I was curious, two, I wanted to see what the scientific data was there,” she said. “I wanted to be able to answer patients’ questions.”
She said she believes there is more research to be done on the therapies. She said she closed her OB-GYN practice when she became public health commissioner in Georgia, and “I will not be practicing private medicine here at CDC.”
Write to Betsy McKay at firstname.lastname@example.org