NATURE | NEWS Trump administration chooses physician to lead US public-health agency

Brenda Fitzgerald will be the next director of the Centers for Disease Control and Prevention.

Heidi Ledford

07 July 2017

Branden Camp/AP/REX/Shutterstock Brenda Fitzgerald has worked to reduce childhood obesity and improve maternal health.

Obstetrician and gynaecologist Brenda Fitzgerald will direct the US Centers for Disease Control and Prevention (CDC), Secretary of Health and Human Services Tom Price announced on 7 July.

“She has a deep appreciation and understanding of medicine, public health, policy and leadership — all qualities that will prove vital as she leads the CDC in its work to protect America’s health 24/7,” Price said in a statement. Fitzgerald has led the Georgia Department of Public Health since 2011, and has championed early- intervention programmes to improve maternal health and counter childhood obesity. Before that, she practised medicine, advised former Speaker of the US House of Representatives on health-care policy, and served in the US Air Force.

“Dr Brenda Fitzgerald is a solid Related stories Related stories choice as the new director of the • Trump budget would • Trump budget would CDC,” said Donna Petersen, chair of slash science slash science the Association of Schools and programmes across programmes across Programs of Public Health in government government Washington DC and dean of the College of Public Health at the • Physician with drug- • Physician with drug- University of South Florida in industry ties is Trump's industry ties is Trump's Tampa, in a statement. “Her FDA pick FDA pick leadership of the Georgia • Gene-edited cows, rogue • Gene-edited cows, rogue Department of Public Health has clinics, speedier drug clinics, speedier drug given her first-hand experience in approvals: the approvals: the dealing with the many challenges challenges facing challenges facing facing state and local health Trump's FDA chief Trump's FDA chief departments.” More related stories More related stories

Fitzgerald's appointment does not require confirmation by the US Senate, unlike many other top government jobs.

At the CDC, she will lead efforts to combat and prevent infectious and chronic diseases. If President has his way, she would have to do so with US$1.2 billion less in 2018 than the agency received in 2017. It is not clear whether Congress will go along with the president's plan, however.

Ten million patients Fitzgerald entered the public-health realm in 2011 when the newly elected Governor of Georgia, Nathan Deal, asked her to advise him on medical issues. Fitzgerald pointed out concerns over the organization of the state’s public-health efforts, and the governor decided to hand her the department's reins. “I really saw my life as going from seeing one patient at a time to going to see ten million at a time,” Fitzgerald said in an interview in 2015. While making that transition, Fitzgerald led a reorganization of the state's public-health programmes, and worked tirelessly to earn extra support — and funding — for her department from a conservative state legislature during a financial downturn, says Phillip Williams, dean of the College of Public Health at the University of Georgia in Athens.

There have been some bumps along the road. In 2014, Governor Deal was reported to have said that the Ebola virus could be killed by water. The gaffe was widely criticized and Deal blamed Fitzgerald, saying that she had misinformed him. But he also emphasized that he still believed her to be competent for her position.

Data driven Through it all, Fitzgerald has maintained a strong focus on mothers and children, which Williams attributes to both her medical background and her emphasis on hard data. "She's very data-driven," he says. "She has established systems to use the data to prioritize her policy- and decision-making."

She also has close ties to the schools of public health in the state, says Colin Smith, a social epidemiologist at Georgia State University in Atlanta and the incoming president of the Georgia Public Health Association. “She’s everywhere, every time I turn around,” he says. “Will that translate to the national level? I don’t know. But I sure know that she’s been a resource for Georgia.”

Fitzgerald has donated money to several Republican politicians over the years, according to a database maintained by the Center for Responsive Politics, a non-partisan group in Washington DC that analyses political donations. Other information collected by the US Open Payments programme, which holds data on the fees physicians receive from drug firms, shows that she received only $14 from pharmaceutical companies in 2015.

Nature doi:10.1038/nature.2017.22235