Koplan to Resign as CDC Director Next Month
In a surprise announcement, Dr. Jeffrey Koplan said yesterday that he will resign as director of the CDC effective March 31, the Atlanta Journal-Constitution reports. Koplan, who has worked for the Atlanta-based agency for 26 years, became director in 1998 after being nominated by former President Clinton. "Key things have been accomplished that I was keen on seeing done. It seemed a good time for me professionally and personally to move on," he said (McKenna/Eversley, Atlanta Journal-Constitution, 2/21). During Koplan's tenure, the CDC's public health responsibilities expanded greatly, with "time and money increasingly dedicated to chronic illnesses and conditions ... and previously unexpected threats," such as bioterrorism, the Washington Post reports. Koplan also helped upgrade laboratory capability at the CDC's headquarters and bolstered the agency-supported network of laboratories at state health departments (Brown, Washington Post, 2/22). Under Koplan, the CDC's budget doubled within three years to $4.3 billion in 2001, and rose to $6.8 billion this fiscal year, an increase largely due to one-time purchases of smallpox vaccines and bioterrorism-related treatments (Terhune, Wall Street Journal, 2/22). "The CDC has been chronically underfunded," Anthony Mazzaschi, associate vice president for research at the Association of American Medical Colleges, said, "but Jeffrey Koplan was an effective and passionate advocate of public funding and public health" (Zitner, Los Angeles Times, 2/22).
But Koplan's tenure will most likely be remembered for the agency's response to the series of anthrax incidents last fall that killed five people and led to thousands of people taking antibiotics, the Post reports. Many people believed that the CDC failed to offer "clear communication and leadership" to local health officials and clinical practioners after the first incidents surfaced, and in particular, should have been quicker to realize that anthrax powder could easily escape from the envelopes that held the bacteria. The agency was also criticized in December when it offered thousands of people who were potentially exposed to anthrax either more antibiotics or a vaccine but did not provide strong advice on the associated risks. It is uncertain whether this criticism had any role in Koplan's resignation. For his part, Koplan said that there was "zero pressure" from the Bush administration to resign. HHS Secretary Tommy Thompson said that Koplan "provided dedicated leadership during very trying times for the CDC and HHS. ... He sets the standard for what it means to truly be a public servant" (Washington Post, 2/22). And William Roper, a "close friend" of Koplan's who headed the CDC from 1990 to 1993 and is now dean of the University of North Carolina School of Public Health, said, "Is he leaving because of anthrax? Of course not" (Los Angeles Times, 2/22).
But the Journal-Constitution reports that acquaintances of Koplan said "privately" that his departure "was the result of tension" between the CDC and HHS, its parent agency (Atlanta-Journal Constitution, 2/21). And the New York Times reports that unnamed health officials said that Thompson and other administration officials "had been unhappy with ... Koplan, contending that he had not given enough emphasis to bioterrorism, a priority for President Bush." The officials also said that Koplan "had not done enough to coordinate the work" of the CDC with senior administration officials in Washington, D.C. In addition, the Times reports that Koplan "often appeared uncomfortable in his public role" responding to the anthrax incidents. When told about the complaints about his bioterrorism priorities, Koplan responded, "That's ridiculous. Whoever gave you that information is either ignorant or malevolent. We have always asked for more money and support than we've received from any source. Bioterrorism has been a priority area from the moment I arrived at CDC. In the last three years, we've put together a laboratory of international distinction capable of isolating and identifying anthrax in a variety of specimens" (New York Times, 2/22).
Koplan's departure will leave another federal health agency without a permanent leader, as the top jobs at the FDA, the Surgeon General's Office and the NIH are also currently vacant. Within the NIH, at least five of the 19 major institutes only have acting directors, and the Health Resources and Services Administration is also lacking a permanent director. Koplan's departure is likely to increase concerns about the lack of leadership among the top federal health agencies. "I am extremely worried that we have these absences at a time when there is attention to health for the usual reasons, and now for the unusual reason of bioterrorism," Dr. Linda Rosenstock, dean of the UCLA School of Public Health, said, adding, "It's a frightening situation to have at a time when you would look for stability in leadership, not volatility" (Los Angeles Times, 2/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.