It’s been quite a few years for the Centers for Disease Control and Prevention. Faced with a barrage of criticism for repeatedly mishandling its response to the Covid-19 pandemic and, most recently, monkeypox, the agency has admitted it has failed and needs to change.
CDC Director Dr. Rochelle Walensky tapped Mary Wakefield — an Obama administration veteran and nurse — to lead a major overhaul of the sprawling agency and its multibillion-dollar budget. Making the changes will require winning over wary career CDC scientists, embattled members of Congress and the general public, who in many cases have stopped looking to the agency for guidance.
“If he can’t fix it, he’ll say, ‘It can’t be fixed, here’s why and here’s what needs to be done,'” said Eileen Sullivan-Marks, dean of New York University’s Rory Meyers College of Nursing, who referred Wakefield. Known professionally for decades.
Other former colleagues said Wakefield’s experience as a nurse, congressional staffer, policy wonk and administrator gave her the perspective and leadership tools to rise to the occasion, even as they acknowledged the enormity of the work ahead.
“He has high standards and expects people to perform,” said Brad Gibbens, a former employee at the University of North Dakota School of Medicine and Health Sciences and acting director of the Center for Rural Health. “He’s very fair, but you have to know what you’re doing.”
Wakefield must navigate rough waters given the agency’s multiple missteps. The CDC botched the Covid testing rollout early in the pandemic, issued misleading guidance on prevention measures like masking and quarantining, and was slow to release scientific findings about the fast-moving coronavirus.
Walensky stressed that, as part of the reset, he wants the CDC to provide Americans with clear, accurate and timely guidance on community health threats.
“I am confident that Mary Wakefield’s appointment will be instrumental in achieving our goals to modernize and optimize CDC,” Walensky said in a written statement. “It is clear that Mary is an action-oriented leader who can lead effective change.”
After an internal audit, Walensky announced plans to restructure how the agency communicates with the public, eliminate bureaucratic redundancies and help the CDC better communicate with other parts of the federal government.
Wakefield’s first day on the job was in mid-August. He declined to speak to KHN for this article, but those who know him paint a rich picture of his management philosophy and style.
NYU’s Sullivan-Marks said Wakefield’s experience as a nurse makes her well-suited to solving the complex set of problems facing the CDC, which she likens to a patient in need of stabilization.
“When you see someone in an intensive care bed, all you see are beeps and lines and monitors going off—people going in and out like a train station,” says Sullivan-Marks. “The nurse is at the heart of it for the patient, pulling them together.”
Sullivan-Marks also said Wakefield’s perspective as a front-line health care worker can help the CDC better understand how physicians will receive and interpret its guidelines and recommendations.
For most of the Obama administration, Wakefield led the Health Resources and Services Administration. HRSA, a division of the Department of Health and Human Services, is responsible for a broad portfolio of programs — those that serve people with HIV, provide compensation for people injured by vaccinations, and file disciplinary actions against health care providers.
Former HHS Secretary Kathleen Sebelius called Wakefield a “change agent” who was able to gain the trust of HRSA staff, many of whom are full-time employees, not political appointees.
“People realized they were there before he arrived and they’ll be there after he’s gone,” Sebelius said. “They had to be convinced that he was a good leader and they were going to follow him. It is significant that he has done so well at that agency.”
(Sebelius is a member of KFF’s board of trustees. KHN is KFF’s editorially independent newsroom.)
Sebelius said that kind of experience could be helpful for Wakefield at the CDC, which employs just over 12,000 people, some of whom may be skeptical of the change. Covid was a serious stress test for the CDC, with some staff wondering if it had lost its way.
Sebelius also cited Wakefield’s experience working with the CDC as acting deputy secretary of HHS as a plus. He was nominated as deputy secretary but was never confirmed due to political conflict over abortion.
Details about the coming changes at the CDC are still emerging, though top officials have said they need congressional support to implement them.
Sheila Burke, head of public policy at the law firm Baker Donelson, got to know Wakefield while working in Congress. He said Wakefield’s experience on Capitol Hill will come in handy when working with lawmakers who sit on committees that oversee the CDC.
“He will be acutely aware of the role of members who care deeply about these issues,” Burke said.
Top health officials have had a hard time justifying the federal government’s pandemic response to certain members of Congress. Walensky and Dr. Anthony Fauci, the Biden administration’s chief medical adviser, who will soon step down, have faced sharp questions from lawmakers on several occasions.
“I think he’s uniquely positioned to understand how you navigate that relationship,” Burke said of Wakefield.
Multiple former employees identified Gibbens at the University of North Dakota as Wakefield’s “unrelenting amount of energy.” He said it wasn’t unusual for him to arrive at work to phone messages that left him at 4:30 in the morning.
He described Wakefield as someone who knows “when someone is trying to play him.” But he also said he doesn’t take himself too seriously. He recalled a kitschy animatronic fish on his office wall, a nod to his love of fishing. And the time he refused to fly on Air Force Two from Washington, D.C. to North Dakota, opting to take a commercial flight “like a regular person.”
“He said, ‘You have to be really careful with that stuff. You don’t want to get used to it,'” Gibbens recalled.
The task ahead for Wakefield may be a stress test of his belief in the humanitarian value of public policy. Walensky said the changes he hopes to implement at the CDC won’t happen overnight, and they likely won’t be easy.
Much like the CDC at present, Wakefield found itself at a potential crossroads in 2005. That year, Wakefield’s brother and two of her children were killed in a car accident that seriously injured her sister-in-law and younger nephew.
“Health policy, previously a focal area of my work, now feels of little consequence,” Wakefield wrote in the journal Forensic Nursing.
Then he got word that his former boss, Sen. Kent Conrad (DN.D.), joined others to introduce the Wakefield Act, a bill aimed at improving emergency medical care for children. Although it didn’t pass, it reminded Wakefield that pulling the levers of government can have real-life consequences.
“They recognized my family’s loss and threw their support behind legislation that could affect the lives of children in other families who might have a chance to live,” Wakefield wrote. “Public policy matters – doesn’t it?”
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