Donald R. Shopland on CDC Reorganization

Author: Donald R. Shopland

If this goes through, it will be twice in the history of the smoking program that CDC had tried to "reorganize" it out of existence. Ironically, it happen the first time exactly 30 years ago when the original National Clearinghouse for Smoking and Health was organizationally transferred to the then newly established Bureau of Health Education and moved from DC to the CDC campus in Atlanta. That reorganization too, was widely promoted as something that will benefit the smoking program.

Once "reorganized" however, the Clearinghouse lost most of its staff and budget -- which was used by the Bureau to support and fund other program activities -- and for a period of years the smoking program was essentially made invisible. Had it not been for Joe Califano and a chance meeting with Dan Horn, the program would have eventually died a slow bureaucratic death and the Office on Smoking and Health would not have been established. No matter how CDC and the administration plays this it will ultimately mean one thing, there will be no central leadership anywhere in government to effectively deal with smoking and health policy issues and major program elements will either die or be rendered meaningless. The Surgeon General report has already been made meaningless for all practical purposes as CDC seems incapable of issuing a report except once every 3-5 years; and was not able to issue a report of any type on the 40th anniversary of the original Surgeon General's report.

As someone who lived through those earlier reorganization changes, I can attest to the negative effect they will have on staff morale, the organizations budget, and its productivity and effectiveness. Without any sort of dedicated central leadership that can provide a strong voice for the organization and its mission, CDC and the administration will be free to promote their own agenda where smoking and health is concerned.

The current OSH and CDC leadership seems more content with title and status than running an effective program that provides true leadership on the issues. We have already seen how CDC and this administration operates with the obesity issue, with the CDC leadership essentially rolling over and caving in to administration pressure. The proposed reorganization is a continuation of a control process that was begun earlier and will simply ensure that no opposing views will emanate from its major health agencies when such issues as FDA regulations over tobacco, are proposed. There simply will be only one voice heard in support of adminsitration policy -- that of the tobacco industry.