Out Flew Enza: CDC's Sweet Beginnings

The DDT-soaked origins of the Centers for Disease Control, and its old friendship with Coca Cola

(This is a near transcript of a similarly titled Tinderbox Podcast episode, found here if you want to listen to the story.)

Today’s story will be broadly about the founding of the American Centers for Disease Control and Prevention. I stumbled on this story as I was trying to understand the CDC’s role versus other health agencies in the federal government. I started wanting to know what the Surgeon General does. I still don’t really know. But in the origins of the CDC, I discovered a story of political and civil drama that I think you’ll enjoy. 

In today’s second edition of Out Flew Enza, we’re going to hear about visionaries and philanthropists, government and the private sector, malaria and mosquitoes, institutional faith, and the ways in which driven people can create legacies. You’re about to find out how the origins of the CDC have a lot to do with Coca Cola. Yes, the beverage in the red can. Remember this?

A bunch of polar bears watching the northern lights. I watched that ad when I was a kid. 

To kick us off, I’m going to take you back just a few years, to a paper published by a magazine called The Milbank Quarterly. Some health care policy experts were extremely concerned about documents they’d turned up and wrote an article about it. 

You too can get your hands on government documents using the Freedom of Information Act, which lets people – I’ve successfully done it myself – lets you request documents from the government on a subject. The subject at hand for the authors was this: what were the soda giant Coca Cola and the Centers for Disease Control and Prevention emailing each other about? You have to wonder why they asked. Maybe they got a hot tip about CDC and Coca Cola being in cahoots. 

The documents revealed a lot of juicy, carbonated information. The authors revealed years of frequent communication between the CDC and Coca Cola, with the soda merchants trying hard to curry favor with the CDC. For instance, in 2014, a newly promoted CDC official got the following email from a Coca Cola science and health officer. Now, I’ve seen a lot of ass kissing in my time, but this is up there. 

“Heartfelt congratulations on being named Director of the Division of Nutrition, Physical Activity, and Obestity at CDC. Once settled would welcome the opportunity to come by and discuss current activities and what more can be done.”

You can’t see it but I’m rolling my eyes right now. The newly promoted CDC official wrote back later, clearly impressed by the butt kissing, trying to get something out of the relationship. 

“I hope you don’t mind if I share the fact that a CDC colleague of mine is very interested in working at Coca Cola… she would be great for external and governmental relations especially on food, beverage, and physical activity policy as well as corporate philanthropy.”

Did you catch all that? the CDC official forwarded on the resume of a CDC colleague to coca cola to be get a job in coke’s government relations department, which you can assume would then be involved with CDC. They call this the revolving door of government and private industry.

Now I could go into much more of the butt kissing communications. There were dinner meetings, promises to work collaboratively on research involving low and no calorie beverages, and so on. Coke was, as every company is, interested in improving its bottom line. The CDC had an entire task force on obesity, doing research on sugars and dietary problems and so on. Coke wanted to influence how the CDC made decisions about obesity.

Here’s a story from Atlanta’s own Channel 2 WSBTV talking about the interaction between the two. Note that both Coke and the CDC are hometown organizations, so this local news report is particularly important.

As an aside, Coke also wanted help getting into the World Health Organization’s good graces. In some other emails to CDC officials, Coke complained that the WHO was influenced by the Chinese Government and unfriendly to private industry. Hmmmm. Interesting. But I digress.

Coke made these moves as the world began to get skeptical about added sugars in food. The CDC has the power to change diets through the results of their research. But it’s hard to blame Coke for lobbying the agency that could ban them. Why wouldn’t try to kiss ass? Coke wants sugary drinks in people’s hands at family cookouts. 

The Millbank Quarterly Article comes to a bold and bombastic conclusion that I’ll read to you right now. “the CDC’s staff allowed conflicted corporate actors to engage in well established tactics to further commercial goals, something that should not occur in an organization established to protect public health.” They continue, saying, “It is unacceptable for public health organizations to engage in partnerships with companies that have a clear conflict of interest.”

Wow! That really sounds terrible, doesn’t it? A public health organization in a revolving door with soda mongers, all surrounding diet. That’s like having a fox in a henhouse. 

Except, it’s not that simple. Yes, coke makes sugary drinks. And yes, the CDC is tasked with disease prevention, including obesity-related disease like diabetes and cancer. But the fox in the henhouse analogy only works if you also acknowledge that the fox helped build the chicken coop. 

I want you to grab your favorite beverage and hold onto that thought about soda and public health, because it comes back around in a big way as we get into how the CDC came to be.

SOUND EFFECT GLUG GLUG GLUG fizzzzz

If you haven’t listened to the last edition of Out Flew Enza, I reviewed the origins of the 1918 pandemic in the camps of Kansas. Or Europe. Nobody knows. Which was part of the problem, actually. The 1918 pandemic wiped the floor with the armies of WW1 and rampaged through the civilian population thereafter. It killed millions and millions of people. It was the worst pandemic since the Black Plague. One of the persistent problems with influenza was sudden onset of pneumonia, which, among other things, filled your lungs with fluid, making you drown in your own juices. 

Well, if you haven’t noticed from the current pandemic, one way that governments react to diseases is to create committees. Now, I personally hate sitting in meetings. Everyone better get to the point because I have things to do, like record podcasts. But meetings and committees do have benefits. Get a bunch of experts together and you find a solution. 

The 1918 pandemic saw the creation of a pneumonia commission that tried to find novel solutions, like new serums, to treat that pneumonia fluid buildup. But as the influenza epidemic wound down, and humanity had learned all kinds of lessons about public health, doctors looking for something to do could turn to other diseases. And one of the number one diseases in the world for mortality was, and has been, malaria. The newly-formed League of Nations dove into the problem headfirst. They created a Malaria Commission in the immediate years after the 1918 pandemic. This group of experts got to do some world traveling, hopping from one malaria infested country to another. What they found dismayed them. Malaria rocked country after country, from Serbia to Italy and beyond. With influenza waning, humanity turned to another threat.

Let me introduce a non-human character into this story. Today, malaria kills three thousand children a day in Africa. A day. It’s killed hundreds of thousands of us ever since there were that many humans to kill. What’s insipid about this villain is that the malarial disease combines the efforts of two tiny monsters that haunt humanity: one of them is a microscopic parasite, and the other is the anopheles mosquito. 

You’ve probably been bitten by an anopheles mosquito. It’s not pleasant. Yes, I am going to keep this audio going just to irritate you. 

Looked at up close, the anopholes mosquito actually uses 6 separate needles protected by a kind of sheath to plunge through human skin, sawing into the blood vessels beneath with tiny lancets. They need bloodmeal protein to go through their reproductive life cycle. That’s bad enough. But it’s what comes along with the mosquito’s microsurgery that kills you. Hitchhiking along with the mosquito are any number of parasites. A mosquito is an airborne dirty needle with its own wants and needs, cruising around your neighborhood, laying eggs in the dirty water in your house’s gutters. 

The mosquito doesn’t exactly want to be the malaria vector. I think. I’ve never asked. But it does a pretty good job of it. 

The actual parasite involved in malaria is a single-celled organism called Plasmodium. It’s not a virus. It’s not a bacteria. It’s a protozoa. Protozoa, unlike bacteria and viruses, are related to us, albeit distantly. It has a cell nucleus, it has defined cell walls. And it sees you as a means to an end. It burrows into your liver and begins to multiply. The resulting infection is called malaria.

Together, the mosquito protozoa alliance make sure that millions of humans suffer from malaria every day. Malaria kills you through acute lung or liver failure. You go through fever and chills and sometimes undergo spontaneous bleeding, blood in the urine, and shock.

This is a disease worth fighting. What I said about influenza in the last podcast I’ll say about malaria: it is a classic villain, one without scruples or morals. It kills with abandon. People who have had it will tell you that it often comes back after you thought you’d recovered. And it seeks to perpetuate itself, using us as the host. 

Here in the United States, it hit us hard. Note the use of the past tense, we’ll get to that. I mentioned the scourge of American malaria in Counted as Cast, the first podcast series we did for Tinderbox. In Counted as Cast Chapter 1 and 2, which I’m sure you’ve listened to by now, you’ll hear how our hero Bill White lived in Eastern Tennessee. Tennessee was, during the height of the Great Depression in the 1930’s, known to be a hotbed of malaria in the United States. Up to 30% of the Tennessee Valley had malaria at any one time. If you’re interested in seeing the successful economic development of your region, you want to see people getting to work. Malaria crippled the workforce. It destroyed families and livelihoods. Demand began to rise, especially during the depression, to bring a stop to it.

Combating malaria in the United States in the first half of the 20th century was one of the heroes of this podcast, a Wisconsin farm boy named Joseph Mountin. Later, Joe Mountin would say that he was born in 1891 the shadow of a grain silo. Mountin would go from the shadow of that grain silo to being one of the foremost figures in American malaria prevention and public health. 

Joe Mountin himself suffered from a bout of diptheria as a kid around the turn of the century, part of an epidemic that killed his brother Ned. Mountin went on to graduate from Marquette with a medical degree and I’d like to think he did so in part because of his brother unfortunate death.

Right after medical school, Mountin joined the Public Health Service, which was the US Government’s first all around attempt at working across the country on creating a healthy citizenry. Here’s the Public Health Service march, because yes, it had one. I guess when you start a new government agency in 1912, you’d get a march written for you.

Mountin was assigned as a scientific assistant in the domestic World War 1 military encampments, working on the health of the soldiers billeted in Kentucky, Iowa, and Texas. This meant Mountin undoubtedly worked to stem the influenza outbreaks we described in the last podcast.

As the war wound down, the Public Health Service assigned him to Missouri, where Joe Mountin started to come into his own as a strategic thinker. Working alongside local health boards and the Red Cross, Mountin started his lifelong dance with malaria prevention and control. At the time, Missouri struggled just as much as the rest of the Southeast, and malaria began to be seen as defeatable. 

From his record, I see signs of Mountin being a steady hand in both the science of disease control and, just as important, the administration of health organizations. In each of his Public Health Service posts, Mountin increased the maturity and complexity of the programs he touched. He seemed to understand staffing and how to get people working in the right places. This skill carried him to Tennessee, where he developed training programs for doctors, and by 1930, to the White House, where he chaired a Conference on childhood health. 

Once, talking about lack of knowledge about the treatment of polio, Mountin was recorded as saying, “There seems to be a lot of ignorance here. Let’s exploit it.” Joe Mountin attacked gaps in scientific knowledge like they owed him money. In general, Mountin looks to me like the kind of public servant a taxpayer wants cloned. 

As his career matured, Mountin understood how to repair fractured systems and stick the right people in the right places to solve stubborn health problems. He was a kind of public health renaissance man, too. He criticized hospital construction with the Works Progress Administration, he worked on statistical analysis of milk sanitation and water pollution, and he developed training in everything from nutrition to malaria control. 

His success, I think, came from a deep drive and a unique spark of creativity, all wrapped up in a down-to-earth mentality. He made fast friends. Coming from a farm, he was able to get knee deep into irrigation canals and relate with rural residents suffering from vicious diseases.

Then the world changed. World War 2 broke out. For the second time in his career, Mountin went back into service of the American war machine. Now a bigwig in the Public Health Service’s interstate program department, Mountin directed resources for the military’s health as it recruited across the states. You see, like in WW1, the army mustered recruits in the southeastern United States before shipping out to fight Nazis and Japanese Empire. You did not want these men to be sick upon arrival in Europe, or die at home like they did from influenza just a few decades earlier. 

One of the most important offices Mountin led was the MiCWAh. That’s what I’m going to call the M-C-W-A, which was the Malaria Control in War Areas project. 

MCWA was Mountin’s creation, a special project with its own staff devoted entirely to destroying malaria in the United States. I’m going to read an excerpt from the CDC history book Sentinel of Health, by Elizabeth Etheridge, where she talks about the early years of the MiCWA. 

“From the beginning, engineers and entomologists dominated. Physicians assessed malaria cases in the field, and parasitologists ran the laboratory, but major emphasis was always on mosquito control, the engineers speciality. They determined control methods, directed operations, surveyed and designed drainage construction projects, and mapped field activities. Entomologists, field commissioned in large numbers in 1943, provided the necessary expertise on mosquitoes. The wartime need to save time, money, and equipment dictated that temporary measures like larvicidal control take preference over permanent drained projects.”

That all sounds noble, right? Government scientists, running around the countryside, saving lives by doing, uh, larvicidal control. You might be asking what larvicidal control entails. Well you remember our anopheles mosquito from earlier, a six-legged bloodsucking menace. The mosquito, as you might know, requires pools of warm water to lay its eggs and complete its lifecycle. Guess what part of the country has lots of warm, standing water? 

Thats right, the southeastern United States. MCWA scientists got right in the middle of that skeeter reproductive process and disrupted it. In Joe Mountin’s words, they were safeguarding “the health of our soldiers, sailors, and workers in defense industries - those that are being trained to do the shooting and those who are providing the guns and materials with which to shoot.” 

A few options were open to them. In and around 1942 and 43, MCWA used Paris Green. Made in part with arsenic, Paris Green has a distinct green coloring and was used in the sewers of Paris to kill rats, hence the name. MCWA decided this was too expensive for the enormous task at hand. Instead, they switched to diesel oil. Yep, they just lined waterways with a mist of oil, deployed by backpack sprayers or with heavier units on boats and trucks. 

Then an enterprising swiss scientist discovered a cheap, chlorine based chemical called, and forgive me for mangling this, Di-chloro-diphenyl-tri-chloro-ethane. You might know this chemical as DDT. At the time, DDT was a miracle of the industrial age. You could spray this stuff on the walls of houses, in yards, spray it in lakes and streams and not only would it kill on contact, but would persist in the environment. For a little over $2, which is about $36 today accounting for inflation, you could make an entire dwelling safe for two months. Mosquitoes didn’t stand a chance. Here’s propaganda audio from San Antonio, TX, supporting spraying DDT just about everywhere: 

MCWA waged warfare across the southeastern united states, blasting open water with chemicals, draining the really stubborn lakes ponds and reservoirs, and making sure plasmodium didn’t take hold in the infantry stationed in the south. The MCWA also dealt with returning soldiers and the exotic diseases they brought from abroad, like whatever terrible illnesses lurked in the jungle of the Pacific theater. Here’s some audio from a training video on communicable lice disease during from WW2 to give you an idea of the organization and effort put into wartime disease control:

The wartime effort was working. Mountin’s MCWA team made an appreciable dent in the malaria cases. The success inspired Mountin. He had already seen a world war and knew what the end of one looked like. In Europe, the Russians and Americans raced to take Berlin. In the Pacific, fighting was ferocious, but the Japanese only lost ground. Mountin had to look forward. He’d spent his professional career building Public Health Service capacity to tackle communicable diseases. Now, under his leadership, he had a cadre of scientists, entomologists, and civil servants seasoned in disease-fighting.  The MCWA, to him, was a model of how a government agency could take on humanity’s worst diseases. He wanted an agency that used the MCWA model to fight more than just malaria. 

As nukes dropped on Japan and then troops began to file home, Mountin scribbled down plans and tried to find support for a new Communicable Disease Center, or, a CDC, that built on the MCWA.  

Like a man possessed, Mountin started fights with anyone who opposed him. He allegedly annoyed the hell out of everyone with this obsession. But he had seen the evolution of public health throughout his career. This was Mountin’s life’s work. He wanted a government agency that could handle complex, interstate disease concerns and undertake complicated research projects that required interstate cooperation.

First, he separated the new CDC from the National Institutes of Health, which would be invested in basic research. He then had to convince individual state health departments to accept oversight and assistance in coordinated response. He won out. Congress chartered the CDC.

But the early CDC started modestly on June 1, 1946. They had a small staff, mostly MCWA veterans, and in Mountin’s mind, some needed to be transitioned to the many other diseases threatening americans. An associate of Mountin’s talked about these growing pains.

“Dr. Moutin was anxious to see his brain child develop as quickly as possible in the direction of laboratory medicine and epidemiology applied to a much broader spectrum of communicable diseases than that which was vectored by insects or rodents. But the earnest efforts toward that goal were thwarted largely by the unavailability between 1946 to 1948 of skilled personnel in communicable disease investigation and control, especially with medical backgrounds.”

In other words, the new CDC struggled not to just focus on the M in MCWA. For a while, they did nothing but malaria control and mosquito elimination because, well, that’s what they were trained to do. Old dog, new tricks. But effective as they’d gotten at malaria eradication, they were physically cramped in various field stations scattered across the south. Various divisions competed for lab space. Discussions occurred about whether to move the operation out of its traditional hub in Georgia. But they had no momentum. Plus, wasn’t Georgia malaria’s ground zero? One of the CDC staff even said later that he was a native Georgian and of course he didn’t want to leave. 

The new CDC, to me, looked a lot like a startup company. It was made up of a lot of dueling personalities, lack of funding, and makeshift offices. The feds weren’t helping, either. The federal government had bigger fish to fry. With Europe smoldering, the United States was poised at the end of the war to become the sole superpower on the planet. My guess is that Congress wanted to see if the CDC could survive on its own. 

First thing was first. A new headquarters. And this point, in 1946, was where Coca Cola enters the picture.

At the time of the CDC’s founding, Coca Cola’s Board of Directors was led by a man with immense business acumen and a propensity for anonymity. It’s that interesting tension of shadowy success that makes the 20th century’s Coca Cola Mastermind, Robert Woodruff, a fun person to research. Let’s digress from the Public Health Service to introduce Coca Cola’s front man. 

Robert Woodruff, born in 1890, was your classic son of a rich man turned adolescent burnout. His father, a prominent Atlanta businessman, tried to get young Robert through college. He failed. Robert Woodruff enjoyed cutting class and spending money. Robert dropped out, turned down a respectable job his father offered him, and instead got his own job at the local pipe factory. He got transferred out of the pipe molding side of the business because he was terrible at molding, and then was later fired from the machine shop because he sucked at that too. If you haven’t sensed it by now, Woodruff’s story is the opposite of Mountin’s. Woodruff was no farm boy and no academic, either. He did not succeed with his hands.

It wasn’t until Robert Woodruff landed a sales job that he started to shine. He took a sales position with a truck manufacturer and quickly advanced to become the company’s vice president. Robert Woodruff knew which opportunities to take and when. When World War 1 broke out and he was drafted, he made sure that the US army only bought trucks from his company. Their profits soared.

Robert’s father, an accomplished businessman himself, noted his son starting to flourish. He had a job for Robert . The elder Woodruff, using his piles and piles of money, had bought a Georgian soda company called Coca Cola. He wanted Robert to run it. 

There was a nice basis for success, too. As any Coke memorabilia collector will tell you, Asa Candler, the previous owner, created a tremendous amount of coke swag. You know, free gifts like napkins, watches, candles, and so on. When the Woodruff’s took control of it, Coca Cola started to get some real market penetration. They’d also already taken out the cocaine and half the caffeine. Bummer. 

When he started the job as president in 1923, at age 34, Robert Woodruff allegedly wanted to make Coke into the “Most American Thing in America.” Robert Woodruff had gone from burnout to business executive. Well, with a little bit of a boost from the old man.

That said, Woodruff had a mind for advertising. He could identify and marshall talent. He brought in Norman Rockwell and NC Wyeth for illustrations. It was Woodruff’s reign in the company that popularized the Coke-swigging Santa Claus, a fat man in a red suit who was, unlike previous depictions, jolly. Why not? Santa had a sugar high. For your listening pleasure, here’s the signature intro music for THE COCA COLA HOUR, on NBC’s Red Network, starting in 1930. Note the Red color, which is good branding. This little ditty played for over twenty years. It was subtle and not in your face like other radio commercials.

https://www.old-time.com/commercials/1930%27s/Coca%20Cola%20Signature.htm

Are you feeling thirsty yet? What you’re feeling is the power of good marketing. Woodruff transitioned Coke out of the pharmacy soda fountains into a bottled beverage you could bring anywhere.

Woodruff insisted on anonymity and opaque business operations. I read one piece that described him as autocratic. For instance, he allegedly kept the secret formula for coca cola safe in a bank vault. Going through some archives of his old letters, I noticed that he didn’t really sign them. Correspondents with him did sign theirs, but he had someone type RWW. This secrecy extended to his charitable work. He started a foundation to make charitable contributions out of his fortune and called it the Trebor Foundation, which you might note is Robert spelled backwards. 

By 1941, as World War 2 started to threaten the United States, Coca Cola had already cemented itself as the new American Apple Pie. War elevated the drink. Woodruff made sure his drink was in GI hands and, in his words, he "would see that every man in uniform gets a bottle of Coca-Cola for five cents wherever he is and whatever it costs." That meant that soldiers going into European villages brought coke with them. Bottling plants sprung up wherever Americans walked, from Europe to the Pacific. Just like Woodruff’s use of the military to make his old car company succeed, he’d taken coke from an Atlanta bottling company to an international sensation.

I swear I will stop at this point and not turn this podcast into a history of coca cola. What you need to know for this podcast is that as he built a soda empire, the orbit of Robert Woodruff, private soda magnate, started to cross with the orbit of Joseph Mountin, public servant. You see, Robert Woodruff had a keen interest in malaria.

The story goes that Robert Woodruff loved quail hunting and it took him to rural Georgia. The story goes that on one of his many quail hunting properties, a worker approached Woodruff. “I just want to meet the new Boss!” the man said. But as Woodruff and his worker talked about hunting and running the ranch, the worker trembled. It wasn’t nerves, either. When Woodruff found out that the man had malaria, and that more than 60% of the residents of Baker County had contracted it, he was incensed. Most of the residents didn’t have the money to afford medication.

Woodruff reacted by showering the county with quinine pills. Quinine is a tropical bark extract that acts prophylactically to stop malaria. You might get a future podcast about quinine, because it’s an interesting story in itself. 

The quinine distribution whetted Woodruff’s appetite for public health. Wanting to continue to help poor southern communities, he used his fortune to begin a decades-long mission to support the Emory University School of Medicine. To picture Emory University, think of white marbled buildings with red tiled roofs. The University had spend years benefitting from the fortunes of a man named Asa Candler, who helped Emory University build its campus in suburban Atlanta. You might recall that Asa Candler was the man who sold Coca Cola to the Woodruff family. The wheel of philanthropy turns. 

But by the time Woodruff got involved at Emory, Candler was long gone. A new family was in town. Like many philanthropists who give a boatload of money to a non-profit, Woodruff ended up with a seat on their Board of Trustees. He funded Emory’s field clinics outside Atlanta to provide free medical services for diseases like malaria. That was a necessity in rural Georgia, where medical care was hard to come by.

Remember MCWA? Mountin’s malaria control agency? It turns out MCWA worked heavily with Emory University and thus, indirectly, interacted with Woodruff’s philanthropic interests. For instance, MCWA could refer sufferers to those same free clinics. MCWA scientists researched malaria control alongside Emory University’s faculty and used their labs for testing. The club of folks working on malaria in the mid 20th century is not large. You start to see Emory, MCWA, and Coca Cola cross paths in efforts to allocate money to defeating malaria. Woodruff had the money, Emory the expertise, and MCWA the public health mandate. It was a triad of malaria control. 

Well, here we are back in 1946, when the new CDC seemed like the red headed step child of the Public Health Service, cramped in a bunch of downtown Atlanta offices, living on government hand-me-downs and competing with the other agency siblings. 

Enter Emory University, driven by one of their chief philanthropists, Robert Woodruff. As far as I can tell, Mountin and Woodruff became aware of each other’s presence during the MCWA years, with their acquaintance brokered by one Dr. Giddings, an old faculty member at Emory. Giddings had spent years and years working with Woodruff to promote public health, and you can probably give him the most credit for cultivating the relationship between Mountin’s crusade and Woodruff’s mountains of money. 

 I’ve read enough low quality scans of old letters to make my eyes bleed. Whether they had a conversation is something I haven’t been able to determine. That would be an interesting podcast in itself. But one thing is certain. For the firesale price of $10, Emory University gifted 15 acres of land adjacent to their Atlanta campus to the fledgling CDC. According to one story, the staff of Emory was encouraged to each give a dime in support of the land transfer. Cute. Emory, led by Woodruff’s persistent voice, aimed to provide the ground on which a headquarters for the shiny new CDC agency could be built. 

Happily ever after, right? In 1947, just a year after the official formation of the CDC, Emory University and Coke’s autocratic executive joined forces to give the US government a generous land grant. Think of it as three legs of the stool: a federal government agency, a private philanthropist, and a non profit university walk into a bar. The bartender says, We only serve pepsi here. 

But seriously, you see that some powerful interests came together to fight a common enemy, a single celled organism carried by an insect with six legs with a straw for a mouth. What could go wrong? The future was bright.

You’re probably saying to yourself, surely Congress recognized that they might have an ally in Woodruff and Emory and therefore allocated the funding to get the CDC a brand spanking new building. Surely they saw how worthwhile it was to chase this lead. Surely Congress saw the value of a public private partnership. 

They did not.

No, the CDC did not get their amazing new headquarters until 1960. Here’s a promotional video someone did of the opening of the new building. 

You know what really disappoints me about that video, beyond the CDC waiting over a decade for their new building? They don’t even use the Public Health Service march for the background music. Whoever left that out should be fired. 

Even though the construction got tied up in General Service Administration and Congressional Bureaucracy, the CDC continued to hammer the environment with DDT and drain swamps and reservoirs. And by 1951, malaria was gone in the United States. Yes, you heard that right. All those decades of fighting had resulted in the end of a mosquito-borne era. The CDC racked up a win that, when you look around the world today, has been replicated very few times. 

Of course, there was that whole DDT scandal, where we almost lost the bald eagle. Biologist Rachel Carson published Silent Spring just two years after the CDC headquarters opened in 1962. In the book, she described the environmental devastation of DDT and chemical warfare in such vivid detail that some think her book was responsible for the Environmental Protection Agency. One government agency spawned another, in a lot of ways.

Sadly, while Joe Mountin lived to see the American demise of his greatest single-celled foe, he never lived to see the completion of the CDC headquarters. He died in April of 1952, leaving behind an agency that has taken on incredible responsibility at the time I record this podcast.  I think Mountin’s premature departure, he was only his early 60s when he passed away, is what kept him from being well known today. 

For his part, Robert Woodruff died three days before I was born, passing away March 7th, 1985. He had a long life as Chair of the Board of coca cola. Today, Woodruff seems to have half of Georgia named after him. His philanthropic reach was tremendous. He and his siblings gifted over two hundred million dollars to Emory University in the late 70’s, an enormous amount of money today and a ludicrous amount of money back then. 

Coca Cola is struggling to sell soda today. Just kidding. Today, Coca Cola is a massive global corporation, though it is still based in Atlanta. And now that you know the story of the relationship between Coca Cola and Emory and the CDC, it brings the CDC/Coka emails into relief. Yes, Coca Cola appeared to have a close relationship with the CDC. But you’d probably be hard pressed to find a time where they didn’t. 

A fun example of that close relationship was the 1983 Joseph W Mountin Lecture. This was a lecture put on by the CDC’s charitable foundation in honor of our man Joe Mountin. Each year, they pick a new speaker. That year’s speaker was Dr. Boisefuillet Jones. Dr. Jones was a Dean of Emory University, then became President of the Trebor Foundation - remember, that’s Robert spelled backwards -, then was invited to give the Mountin lecture at the CDC. Can you get any more incestuous? 

When all that news broke about the emails between CDC and Coca Cola in 2017, the director of the CDC was a woman named Dr. Brenda Fitzgerald. She came into the position highly qualified, highly educated and having acted as Georgia’s commissioner of public health. I want you to take a wild guess as to where she went to school. That’s right, Dr. Fitzgerald was a graduate of Emory University. 

Incidentally, Dr. Fitzgerald resigned as the director of the CDC in January of 2018 after it was revealed that she had investments in a Japanese tobacco company while running an anti smoking campaign at CDC. Georgetown-educated virologist Dr. Robert Redfield Jr. took over from her in March of 2018. He wasn’t in the position for two years before the Covid-19 pandemic hit. 

It’s worth taking a breath now as I wind down this podcast, because we have now completed the goal, namely understanding the beginning of the CDC. Mountin was building something out of nothing, capitalizing on immense ignorance, and writing a new book of public health. Woodruff revolutionized advertising, giving America characters like jolly Old St. Nick. With the help of those around them, these two men brought to bear the forces of cheap pesticide and bottled sugar syrup. What resulted were whole new realities for American life.

What’s interesting, and maybe a little shocking, was how the private sector gifted resources to the public sector voluntarily. Out of the goodness of their hearts. Hmm… It seemed like Woodruff supported Mountin’s initiative because he believed in it.  

I am having a hard time imagining this happening today. It likely happens in some sectors, like defense. You see a lot of the large defense contractors attached at the hip to the federal government. But I really doubt that department of health and human services has lately seen many people gifting them large parcels of land. Near my own home, a farmer gift land to the state to become state gamelands. But he got paid for it.

You’ll hear billionaires like Warren Buffet saying that he wants to pay more taxes, in other words, give more of his property to the government. What always annoyed me about his statement, though, is that anyone is welcome to pay more taxes if they feel like it. The IRS has a form for that. You too can do your part to reduce the national debt.  I’m sure that goes for your local taxes too. If you think schools are underfunded, you’re welcome to call up your local school board about a donation. 

Now, Norway rolled out a voluntary tax system in 2017. In the first month, they raised the equivalent of $1,325. 

So what happened in the 1940s? Why did this partnership between government and private industry happen? I want to throw two possible explanations out there for you to chew on. The first idea I want you to consider is nice and controversial. I want to argue the value of... patronage networks. In this case, you had lines crisscrossing between government and wealthy and non-profits and back again. And it worked. 

The libertarian in me screeches in horror. Government, picking winners and losers? No! The left leaning part of my brain screams too. Isn’t it quid pro quo corruption? That’s not how government is supposed to work!

We can all take a deep breath. I just wonder whether a certain amount of favoritism and corruption shortens the way to a solution. Hear me out for a second. Don’t throw your phone just yet. In my time working, I’ve met a lot of people who are terrible at their jobs, radically conservative about any change to processes and business practices, and probably unable to recognize a novel solution if it meant unemployment. I’ve seen them sink their own businesses out of stubbornness. You know the type. They are the ones that hold an organization by the gonads, preventing it from going to the next level. They were the people that, according to many sources, Mountin had to fight in his quest to create a CDC. 

Congress didn’t grant Mountin the money needed, so he turned to the private sector. Is that corruption? I’m not sure. It’s patronage of some sort. But I’m wondering if in many ways, patronage systems have the ability to identify the most solid links in the chain. If all ideas and workers are equal in front of the bureaucracy, you have fairness. But you might lose a chance at identifying excellence. And then, from what I can see, Coca Cola and Emory benefitted for decades afterward, at least up until they were caught red handed. Yes, I picture a CDC scientist with a coke in their hand getting caught mid sip. 

I know. Someone is ready to give me a one star review on itunes for this. I’m not saying I am totally on board with this all the time. But I don’t think it’s a clear cut issue. Something worked in this case. And I imagine that if you think back, you can think of once or twice where some corruption did make things work better. Perhaps, in human societies, there’s a healthy amount of corruption. Where’s that level? How do you know you’re at the right level? That’s the real question.

The other idea I wanted to raise is a pretty obvious one. But it also has deep implications. That’s a Faith in institutions. Everyone involved in this story believed in an idea, the eradication of malaria and other diseases, and they believed a solution was possible. They followed through. By spraying enough caustic chemicals and putting manpower into place, malaria was exterminated from the united states. Today, the CDC only does surveillance of malaria, because the cases are all foreign. They retooled their entire workforce away from the old MCWA work into other concerns, like typhus, HIV, and today, coronavirus. Eradication of malaria meant the thriving of so many more families in the south. The spiritual, social, and economic benefits are immeasurable. 

The private sector’s faith in this slice of the federal government was deep. The CDC agency’s faith in the private sector was reciprocated. There was a faith in an institution, maybe because the end of malaria was in sight. 

But I wonder if, in the mid 20th century, the problem of, say, defeating malaria was solvable because it wasn’t that hard of a problem to solve. 

A few years ago, some Stanford University economists introduced some bad news about breakthroughs in the hard sciences. This group had data to show that scientific breakthrough is slowing down. The paper was called ARE IDEAS GETTING HARDER TO FIND? Their thesis was that new ideas and problem solving now requires more brains, more time, and more money. Everyone loves to cite Moore’s law, which is that microprocessors double in speed every two years. This research group found that the concept still held, but now you needed 20 times as many personnel to achieve that doubling of speed. Research teams are getting bigger but the number of patents and novel products they produce is going down.

This is my long way of saying that the early and mid twentieth century may have been a time of hope for institutions because the problems those institutions solved were smaller, more discrete, and easier to tackle. Today, those same institutions have to deal with staggering problems. Look, for instance, at what the CDC was working on when they got into trouble with Coca Cola. Obesity. People being overweight costs the United States billions of dollars a year, if not trillions when you account for all downstream effects like lost productivity. Obesity kills prematurely and causes a variety of illnesses that cripple people. If we could spray chemicals and drain swamps to stop obesity, I am sure that someone would call for it.

But it’s not a simple problem. There’s so many variables. Individual behavior, cultural cuisine, exercise and sedentary lifestyles, medication, pollution, genetics. MCWA’s effort to fight malaria took place over about ten to fifteen years, with two decades of work before that. CDC’s effort to fight obesity will likely take twice as long. The problem has not gotten any better despite the billions of dollars thrown at it. Back in the malaria eradication days, you could drain a few ponds and dump some chemicals and that town was checked off the list. There’s no town today where obesity has been defeated. 

We form institutions to solve problems. And at one time, they could. 

Now, you could counter me by saying that, Will, MCWA and the CDC was able to eradicate malaria because they were using DDT. It caused all kinds of problems. DDT not only kills insects indiscriminately but it’s a human neurotoxin. And on top of that, you might say, the CDC today is not the CDC of yesteryear. They don’t seem to be as proactive or empowered. And you’d likely be right on both counts. Still, something changed in the last eighty years.

In that time, we’ve come into a world where we face pandemics, rising seas, and nuclear annihilation. The demands on our institutions, private and public, have increased. Problems are harder than ever to solve. Every solution requires sacrifices we may not be willing to make. 

But if we need new institutions to solve complex problems, those organizations don’t just appear. They’re products of driven people. Look to the example of Mountin and Woodruff, both eccentric and often obsessed. Their types are irritating and single-minded. After a few conservations with them, you’re ready to fire them, ignore them, or otherwise get them out of your face. But they also might be exactly the characters we need for the problems we face today. 

Thank you, and stay healthy out there in the tinderbox.

Works Cited

Works Cited

Etheridge, Elizabeth W. Sentinel for Health: a History of the Centers for Disease Control. University of California Press, 1992. 

“Historical Perspectives History of CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/mmwr/preview/mmwrhtml/00042732.htm. 

Troy, Gil. “The Doctor Fauci of WWII Beat Malaria in America-and Founded the CDC.” The Daily Beast, The Daily Beast Company, 26 July 2020, www.thedailybeast.com/dr-joseph-mountin-the-doctor-fauci-of-wwii-beat-malaria-in-america-and-founded-the-cdc.

Hessari, Nason Maani, et al. “Public Meets Private: Conversations Between Coca-Cola and the CDC: Milbank Quarterly.” Milbank Memorial Fund, 30 Oct. 2019, www.milbank.org/quarterly/articles/public-meets-private-conversations-between-coca-cola-and-the-cdc/.

Kelley, Bob (2015). Images of America, Centers for Disease Control and Prevention. Charleston, South Carolina: Acadia Publishing. p. 9.

Roemer, M I. “Joseph W. Mountin, Architect of Modern Public Health.” Public Health Reports (Washington, D.C. : 1974), U.S. National Library of Medicine, 1993, www.ncbi.nlm.nih.gov/pmc/articles/PMC1403455/. 

Seegmuellertom.seegmueller@albanyherald.com, Tom. “Coke Mastermind Woodruff Had Huge Impact on Southwest Georgia.” Albany Herald, 8 Mar. 2021, www.albanyherald.com/features/coke-mastermind-woodruff-had-huge-impact-on-southwest-georgia/article_8c3f5b40-4521-11ea-beff-43415ed8f3b1.html.

Person. “'A Friend of the Community': How Robert Woodruff Helped Bring the CDC to Atlanta.” EIN Presswire, Coca Cola, 22 Nov. 2014, www.einpresswire.com/article/236069929/a-friend-of-the-community-how-robert-woodruff-helped-bring-the-cdc-to-atlanta.

Zainaldin, Jamil. “How Georgia Gave Birth to the CDC and Helped Fight Malaria (Part 2).” SaportaReport, 4 Nov. 2013, saportareport.com/how-georgia-gave-birth-to-the-cdc-and-helped-fight-malaria-part-2/archived-columnists/jamils-georgia/nge/.