Evidence, Trust, and Prevention: David J. Weber, MD, MPH, on CDC Leadership and Public Health

The sudden departure of the CDC director with several other top leaders has raised urgent questions about the stability of the nation’s leading public health agency and its ability to provide consistent, evidence-based guidance. In an interview with Infection Control Today^®(ICT^®), David J. Weber, MD, MPH, president of the Society for Healthcare Epidemiology of America, and the medical director of the Department of Infection Prevention at UNC Medical Center, emphasized why strong leadership, scientific integrity, and prevention-focused strategies are essential for protecting both patients and communities.

“The Centers for Disease Control in the United States has been not only the leading public health agency within the United States, but look to worldwide,” Weber said. It “provides crucial guidelines for us in infection prevention, vaccines, but many other aspects of public health,” and serves as a vital conduit for federal support: “It serves as a pass-through for congressional funds…to state and local health departments to provide public health interventions.”

For Weber, the compass is clear: “We believe in public health guidelines should be evidence-based on peer-reviewed published literature.” The CDC’s surveillance role allows health systems to “direct the resources to the areas that are most impacted,” while transparent guidance spans prevention in hospitals and community vaccination. He underscored historic gains: “The two most important public health interventions in the last 150 years have been a safe drinking water supply and second, vaccines,” noting we have “eliminated smallpox… eradicated two of the three types of polio…and dramatically decreased…mumps, rubella, whooping cough, and…measles.” CDC laboratories also safeguard against the rare and the dangerous, from “human rabies” to “Ebola and Lassa.”

Selecting a new director demands depth and credibility. “That person should be a physician…[with] substantial experience in…public health,” and “enough of a scientific background…to follow the best evidence-based practice.”

Funding cuts, Weber warned, ripple locally. “Only about 5% or less is staff…but still, the majority of money is just a pass-through to state and local governments.” Proposed reductions “will…affect every person in the United States,” because they would “dramatically affect…city, county and state public health departments.”

At the bedside, fundamentals still save lives. “Proper hand hygiene before and after each patient in contact,” surface disinfection, and appropriate precautions are “the very basic things we do.” The economics align with the ethics: “For every dollar we spend on infection prevention, we save more money than we spend… Prevention is always better than treatment.”

The charge to clinicians is unambiguous: “We need to be the proponents for a safe and effective therapies…to counter both misinformation and disinformation.”