WASHINGTON – Recent Bush administration audits of the Centers for Disease Control and Prevention have provoked complaints from center officials who say they are suffocating under strict oversight of the public health agency.
But others say the reviews, especially of HIV/AIDS prevention funding, are long overdue.
According to officials in the inspector general’s office at the Health and Human Services Department, which oversees the Atlanta-based CDC, all HIV/AIDS-related programs are currently under review, as well as other grants and contracts administered by the health agency.
The review comes on the heels of a report last year that found that one San Francisco-based organization was using taxpayer dollars to fund HIV/AIDS prevention programs that featured drag queen beauty pageants and masturbation demonstrations that were deemed inappropriate under government guidelines.
"It seems that the CDC has been influenced by various political agendas instead of a strict political mandate," said Rep. Dave Weldon, R-Fla., a physician who has been working in Congress on the issue with Rep. David Souder, R-Ind.
But CDC advocates say that while a healthy monitoring of taxpayer funding is wise, the Bush administration has created a culture of tension and micromanagement that is threatening the efficacy of the CDC, which is responsible not only for epidemiological studies, but for quick-action responses to epidemics, disease and public health threats that range from Ebola to anthrax.
"In my experience, the first year under any new administration, Republican or Democrat, the particular agencies are very active in trying to respond to the political agenda of the administration in power," said William Cates, the president of Family Health International, who also worked for the CDC for over 20 years.
"Regardless of that, it seems to me that there has been a more restrictive and sort of micromanaging oversight from the standpoint of this administration that has continued beyond that first year and has tended, in my mind, to harm us rather than build on the collective expertise at the CDC," he said.
Cates pointed to the distraction caused by heavier scrutiny of internal affairs like travel expenses, departmental approval of all CDC press releases and a dictate that the CDC – which has often acted in a semi-autonomous nature from the White House – speak in "one voice" with the administration.
Others say the CDC – among whose ranks are some of the most vocal health activists in the nation, taking on issues as far afield as gun control and condom use – is in dire need of a wake-up call.
"To me, keeping an eye on people working on HIV prevention at the CDC is like keeping an eye on Enron and the firms that do accounting for Enron," said one Republican House staffer who did not want to be identified. "Why are we funding them if they do the same bad things over and over again?"
In 2002, HIV/AIDS-related CDC programs received $144 million in funding while the CDC overall received $6.8 billion.
"I would like to see more audits performed on the HIV/AIDS program funding in San Francisco at the STOP AIDS Project," said Michael Petrelis, about the San Francisco project that received $698,000 in CDC funding in 2000 for events named "Booty Call" and "Great Sex Workshop" that offered "hands-on" exploration of safe sex techniques and other explicit demonstrations for gay men.
Petrelis, a gay man living with AIDS who brought his concerns about the project’s programs to the attention of Capitol Hill lawmakers, said the programs do nothing to curb the spread of HIV and AIDS.
"[The programs] are offensive and they are also ineffective in stopping the transmission of HIV to gay men in San Francisco," Petrelis said.
The CDC and the HHS would not comment on the audits being conducted on the agency, or of the critics’ complaints of tension between the administration and the agency.
But Kitty Bina, a spokeswoman for the CDC, said all of their programs dealing with HIV/AIDS are approved by local panels who know the guidelines and are the best judges for what is going to work in their communities.
"What works well for San Francisco may not work for Birmingham, Alabama," she said. "HIV/AIDS has always provoked strong political and moral objections. Our job is to mind what is in the best interest of public health."