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Redefining the CDC’s Role in a Public-Private Health Partnership Era

For nearly eight decades, the Centers for Disease Control and Prevention (“CDC”) has stood at the center of America’s public health defense—once a nimble wartime agency, now a sprawling institution facing questions about its identity, effectiveness, and authority. As politics, pandemics, and public distrust reshape the health landscape, the agency’s next chapter will determine not only how the U.S. responds to future crises but also how effectively it can partner with the private sector to deliver comprehensive health solutions. This piece examines how the CDC’s evolution—from malaria control to pandemic command—has shaped today’s health system, the essential role of private sector innovation, and what it will take to build a coordinated, credible national health infrastructure through public-private collaboration.

When the CDC was founded in 1946, its mission was clear and urgent: stop the spread of malaria among troops returning from World War II.¹ The agency was, at its core, a wartime public health operation, a band of scientists and “disease detectives” armed with data, microscopes, and mosquito spray. In the decades that followed, that narrow mission expanded dramatically. The CDC evolved from a disease control bureau into the nation’s de facto guardian of public health, tackling everything from chronic disease and environmental hazards to emergency preparedness and global health security.

Today, the CDC sits at the center of a vast ecosystem where public and private health entities must work in concert. America’s public health delivery system isn’t a single chain of command; it’s a dynamic network of federal, state, and local authorities alongside private healthcare providers, pharmaceutical companies, technology firms, and community organizations. At the federal level, agencies such as the CDC, the National Institutes of Health (“NIH”), the Food and Drug Administration (“FDA”), the Health Resources and Services Administration (“HRSA”) and the Biomedical Advanced Research and Development Authority (“BARDA”) establish frameworks within which private sector innovation can flourish.

Evolution of Public-Private Engagement

The CDC has long recognized the value of private sector expertise, though implementation has been inconsistent. After September 11th and the 2001 anthrax mail attacks that killed five people and exposed national gaps in biosecurity, the federal government overhauled its public-health preparedness system, creating the Office of the Assistant Secretary for Preparedness and Response (“ASPR”) and BARDA to strengthen coordination and accelerate private sector development of medical countermeasures.²

During the 2014 Ebola crisis, the CDC regained stature as a steady, science-based voice while working alongside pharmaceutical companies to accelerate vaccine development. Under Director Tom Frieden, the agency deployed thousands of staff to West Africa, established infection-control standards in partnership with hospital systems, and communicated with clarity and evidence amid widespread fear, reinforcing public trust in its scientific leadership.³

However, early testing failures during COVID-19, followed by shifting guidance and communication missteps, revealed gaps in public-private coordination.⁴ Congress held hearings and floated reforms but ultimately failed to pass major structural changes that would formalize private sector integration.⁵ Meanwhile, the growing authority of ASPR under the Pandemic and All-Hazards Preparedness Act, combined with the rising influence of private entities in public health response, created opportunities for a reimagined CDC role focused on enabling and coordinating private sector capabilities.⁶

Now, the CDC has the opportunity to redefine its mandate as a scientific authority that empowers private sector innovation while maintaining public health standards. This requires establishing clear mechanisms for private sector engagement, data sharing, and coordinated emergency response.

The Ecosystem of Public Health Partners

In addition to the complicated landscape of federal agencies with roles in public health, local health departments, approximately 3,300 nationwide, serve as the frontline. They administer vaccines, manage outbreaks, conduct restaurant and water safety inspections, and lead community education and prevention efforts. State departments of public health interpret and operationalize much of the federal guidance. At both the state and local level, the structure, capacity, and span of control of these departments vary significantly.⁷

In theory, this distributed model allows for flexibility and local tailoring. In practice, uneven funding, workforce shortages, and political pressures result in significant variation in readiness and response capacity. These disparities highlight the critical need for private sector involvement to fill gaps and enhance capabilities across jurisdictions. In communities where hospitals, primary care networks, pharmacies, and trusted local organizations are fully integrated into public health planning, surveillance, outreach, and emergency response capabilities are dramatically enhanced. The private sector brings not only additional resources but also innovation, efficiency, and community trust that government agencies alone cannot achieve.

Defining Roles in Public-Private Health Partnerships

When a virus spreads or water is contaminated, the CDC leads at the national level - tracking outbreaks, analyzing data, and issuing guidance. States step in to enforce quarantines, manage investigations, and deploy resources. Local departments become the boots on the ground: tracing contacts, vaccinating residents, and calming fears. Alongside these governmental roles, private actors serve as essential partners in the public health ecosystem. Health systems manage surges in patient care and implement infection control. Labs scale up testing and share critical data. Pharmaceutical and biotech companies develop and distribute vaccines and diagnostics. Community-based organizations help communicate guidance and reach populations that other efforts might miss.

This multilayered model works - but only when trust, clarity, and leadership flow from the top all the way down to the bottom, with strategic private sector engagement at every level. And that’s exactly where opportunities for improvement have emerged.

Formalizing the Role of the Private Sector in Effectively Protecting the Public’s Health

While the CDC’s mission has expanded and the federal landscape has grown increasingly more complex, there is no question that public health emergencies require a coordinated response from all stakeholders. The CDC’s mandate should clearly establish its role as the scientific authority that sets standards, provides guidance, and coordinates the integration of private sector capabilities into public health response. This includes creating formal mechanisms for private healthcare systems, pharmaceutical companies, payers, technology firms, and community organizations to participate in planning, surveillance, and emergency operations.

At the same time private actors should be recognized as the essential partners they are, not merely resources supplemental to public health. Hospitals, health systems, pharmacies, employers, payers and technology companies possess capabilities, reach, and community relationships that can dramatically enhance public health outcomes when properly integrated into a coordinated system. The CDC should establish clear frameworks for data sharing, joint planning, and operational coordination that leverage these private sector strengths while maintaining public health standards and equity.

Private actors have always been integral to public health responses, but their role must be formalized and expanded through structured partnerships as the healthcare landscape evolves. During the COVID-19 Pandemic, we witnessed how private companies filled critical gaps in the public health infrastructure - from rapid test development to vaccine manufacturing and distribution networks. When official communication lagged, private healthcare organizations, employers, and technology companies stepped in to interpret and disseminate guidance, demonstrating the untapped potential of public-private collaboration.⁸

The growing reliance on private actors without an aligned and coordinated federal, state and local public health strategy has resulted in widening variability across states. Florida, for example, has rolled back vaccine mandates, arguing for medical freedom over federal guidance.⁹ While states like California, Oregon, and Washington have doubled down, forming regional health alliances to coordinate pandemic response and climate resilience.¹⁰

The result: a country operating with 56 different public health playbooks. The Texas measles outbreak, for example, revealed what happens when communication breaks down - delayed interventions, community confusion, and declining vaccination rates that reignite once-contained diseases.

Building a Resilient Public Health Ecosystem

The CDC’s recent challenges underscore the need for a more integrated and clearly defined public health operating model. Over time, expanding expectations have stretched the agency across a wide and growing mandate, complicating its ability to execute core functions with speed and focus. Establishing clear mechanisms for private-sector engagement allows the CDC to better leverage external expertise and capacity while maintaining its essential leadership and oversight role.

Advancing this model will require more than internal adjustments alone. It demands a renewed, national consensus on what public health is, what we expect the government to do in protecting it, and how the private sector can be systematically engaged to support that mission.

As measles, mpox, and new COVID variants remind us, the cost of fragmentation is measured not in headlines but in human lives, making it imperative that CDC reclaim its role as the nation’s trusted public health coordinator before the next alarm rings - with private sector partners fully integrated into the response framework.

Reimagining the CDC’s Mandate

The CDC’s future depends on establishing a clear mandate that explicitly incorporates private sector partnership. America needs a public health system that leverages the strengths of both government agencies and private organizations. Outbreaks don’t respect borders, and rebuilding public trust requires leadership that’s nimble, transparent, and coordinated across sectors.

Reform should focus on creating formal mechanisms for private sector engagement. The CDC must refocus on what it does best: science, surveillance, and strategic action to prevent health, economic, and national security risks posed by outbreaks. It must modernize its communications to meet an era where social media outpaces official statements. Most importantly, it must establish structured partnerships with both state and local departments and the private healthcare delivery system that Americans rely on for their care.

Operationalizing Public-Private Partnership in Community Health

To succeed in today’s rapidly shifting public health landscape, organizations must develop structured approaches to cross-sector collaboration. This means creating formal mechanisms for private healthcare providers, community organizations, and government agencies to work together toward shared public health goals.

The CDC should develop clear frameworks for private sector collaboration, including:

Formalized data-sharing agreements with healthcare systems and payers
Joint emergency response protocols with private healthcare providers
Collaborative research initiatives with pharmaceutical, biotech and health technology companies
Strategic communication partnerships with payers and employers
Funding mechanisms that incentivize private investment in public health infrastructure

Effective collaboration between public health departments and the private sector is not just beneficial but essential to improving population health outcomes. Well-designed public–private partnerships bring together complementary expertise, resources, and operational capacity, allowing innovation developed in one setting to scale, reach, and sustain impact across communities.

Private sector organizations can help accelerate progress by:

Sharing their knowledge and capabilities regarding leveraging advanced data systems, digital health tools, and analytics platforms Developing community-based care delivery models that extend the reach of public health initiatives
Contributing specialized expertise in logistics, communications, and technology implementation
Sharing operational infrastructure to support rapid response capabilities

When structured well, public–private partnerships deliver mutual value: they expand access to care and prevention, strengthen community trust, promote innovation, and position private organizations as leaders in driving meaningful, system-wide health improvement.

Our team has deep experience facilitating effective public-private partnerships to address urgent public health priorities. We’ve seen firsthand that the most successful initiatives are those that intentionally align public and private priorities through formal collaboration frameworks. Success depends on creating structured mechanisms for engagement that build (or re-build) trust, strengthen credibility, and drive measurable impact across the healthcare ecosystem.

Emma Winstead, a Senior Consultant in the Strategic Communications segment at FTI Consulting, contributed to this article.

Footnotes:

1: “The History of Malaria in the United States”, CDC (2024).

2: Joseph C. Larsen, Gary L. Disbrow, “Project BioShield and the Biomedical Advanced Research Development Authority: A 10-Year Progress Report on Meeting US Preparedness Objectives for Threat Agents”, Oxford Academic (February 4, 2027).

3: The Road to Zero: CDC’s Response to the West African Ebola Epidemic, 2014-2015.

4: “Historically Unprepared: Examination of the Federal Government’s Pandemic Preparedness and Initial COVID-19 Response”, Senate Committee on Homeland Security & Government Affairs (December 2022).

5: “Peters Investigation Finds Significant Failures in Federal Government’s Pandemic Preparedness and Initial COVID-19 Response” Senate Homeland security and Government Affairs Committee (December 8, 2022)

6: “Pandemic and All-Hazards Preparedness Act Reauthorization: Background and Opportunities to Enhance Resilience” Healthcare Distribution Alliance.

7: Josh Michaud, Jennifer Kates, Stephanie Oum, Anna Rouw, “US Public Health”, KFF (October 8, 2025).

8: Giacomo Tognini,“Coronavirus Business Tracker: How the Private Sector is Fighting The Covid-19 Pandemic” Forbes (April 1, 2020).

9: James Oliphant, Julie Steenhuysen, “Florida plans to end all state vaccine mandates, including for schools” Reuters (September 4, 2025).

10: “California, Oregon, and Washington to launch new West Coast Health Alliance to uphold scientific integrity in public health as Trump destroys CDC’s credibility” (September 3, 2025).