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Republican lawmakers argued that the CDC has overstepped its mission and needs to narrow its scope to communicable diseases during a of the House Energy & Commerce Health Subcommittee on Tuesday.

The proposed House Appropriations Subcommittee Fiscal Year 2025 bill for the Labor, Health and Human Services, Education, and Related Agencies Subcommittee cuts CDC funding by 22% and eliminates 23 "duplicative and controversial programs," while boosting funding for emerging and zoonotic infectious diseases, according to a .

Subcommittee Ranking Member Rep. Anna Eshoo (D-Calif.) noted that the cuts amount to a $1.8 billion reduction over the previous year. Meanwhile, the U.S. is short 80,000 public health workers, she said.

"We've set up the CDC and our local public health agencies to fail," she added.

Eshoo was particularly disappointed by the proposed elimination of the National Center for Injury Prevention and Control (NCIPC), which helps to protect women, children, and families from domestic abuse.

"Public health ... has become a casualty of partisanship," she lamented.

Rep. Dan Crenshaw (R-Texas) was one of several members to voice support for narrowing the agency's scope, noting that most Americans would agree.

"I think they view the CDC as the people who go out and quickly address a communicable disease that is new and novel and dangerous," Crenshaw said. "It's supposed to be an operational organization."

He pointed out that many of the agency's activities are duplicative. The substance abuse components of the CDC mirror the Substance Abuse and Mental Health Services Administration (SAMHSA), and the agency's chronic disease programs overlap with the NIH, he said.

However, NCIPC Director Allison Arwady, MD, MPH, noted that more than 80% of the CDC's funding is directed to state and local programs.

For 8 years, Arwady led the Chicago Department of Public Health in addressing the fentanyl crisis. She explained that the $300 million her department received through the CDC's transformed the city's response to the crisis, enabling the department to invest in epidemiologists and geographic information system specialists, and to trace where a threat was and how it was changing.

It also helped her department develop a coordinated strategy for connecting those who survived overdoses to care, often in SAMHSA-funded treatment facilities.

Crenshaw did applaud the agency's work investigating fentanyl in wastewater.

"Now that's the kind of thing we should be doing ... focusing on a problem that Americans have," he said, despite the fact that the proposed appropriations bill would gut the funding for programs that support this work.

Crenshaw also questioned other initiatives, such as the CDC's which provides the preferred terms for special populations, including "people who inject drugs" instead of "drug users" and "people who smoke" rather than "smokers."

"Why is anyone at the CDC spending time on speech codes?" he asked.

He also highlighted a CDC report titled, "," noting, "Nobody likes racism, but again, is it a communicable disease? And how so?"

Arwady reminded subcommittee members that the CDC's role extends beyond communicable diseases.

"CDC's goal is to protect health and improve lives, and the leading causes of death -- different than 100 years ago when it was infectious diseases -- is related to non-infectious diseases," she said.

Vaccine Surveillance

Rep. Earl "Buddy" Carter (R-Ga.) argued that the CDC's core mission to address communicable diseases has been "diluted" since the agency launched in 1946, and now includes environmental justice, deforestation, firearm deaths, and social determinants of health.

He also pointed out that taxpayer dollars were being spent on phoning constituents to ask whether or not they had been vaccinated for COVID-19.

"I understand the importance -- trust me -- of making sure you've got the information that you need. I get it. But at the same time, it's critical for these agencies to respect the freedoms and the privacy of Americans," Carter said.

Demetre Daskalakis, MD, MPH, director of the CDC's National Center for Immunization and Respiratory Diseases, said that surveys help identify areas where, for example, uptake for measles, mumps, and rubella vaccines have declined, which helps the agency implement catch-up strategies. It's the populations with lower vaccine coverage that are most susceptible to illness, he added.

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