The following is a conversation between Dr. Judith Monroe, President and CEO of the CDC Foundation, and Denver Frederick, the Host of The Business of Giving.
Denver: The CDC Foundation is an independent nonprofit and the sole entity created by Congress to mobilize philanthropic and private sector resources to support the Centers for Disease Control and Prevention’s critical health protection work. As such, they’ve been in the news and busier than ever this past year. And here to talk about that work and what’s coming next, it’s a pleasure to have with us, Dr. Judith Monroe, the president and CEO of the CDC Foundation.
Welcome to The Business of Giving, Judy!
Dr. Judy: Thanks for having me. Great to be here.
We were actually created by Congress to help support CDC’s mission to protect health, and we support not just CDC, but public health in general.
Denver: Tell us about the foundation and how you help support the CDC and, in turn, public health protection.
Dr. Judy: Thanks for the question. I’m very passionate about our work. The CDC Foundation is a well-kept secret in many circles I’ve learned as I’ve been the CEO. But we were actually created by Congress to help support CDC’s mission to protect health, and we support not just CDC, but public health in general. We’ve got a broad mandate.
And the way we go about that is typically, CDC will come to us with a need, a gap in the work that they want to do where they need public-private partnerships or philanthropic support, and then we will go to work finding that support. So, we’re not an endowed foundation. We do go out and find our partners, and we’ve got numerous partners over the years that we’ve built, which we’re really appreciative of our donors.
And the way we do that is we’ve also got program officers. So once a program has been funded and we’re going about the work, we’re right in there with CDC and perhaps partners from health departments globally, with ministers of health and other partners on the ground, and we go to work to achieve whatever it might be.
So that ranges all the way from infectious disease, malaria, lymphatic filariasis are some of the neglected tropical diseases that we work on. And then here in the United States, all the way from data systems to maternal mortality, infant mortality. It’s a very broad mandate.
Denver: That’s a good description. So what you really do is you help amplify, essentially, and do some things that they would have a difficulty doing themselves, and you can do faster and quicker and better or whatever the case may be to achieve mission.
Well, you’ve been around, as you said, you were founded by Congress in 1992. So, it’s been about 30 years. What have been some of the most notable achievements over that period of time?
Dr. Judy: So I think some of the visible achievements that folks maybe have heard about have to do with emergency response. So as an example, during Ebola we all will remember the intensity and the heightened news cycle around Ebola.
Well, in West Africa, there were really major challenges. And so, CDC, because of our speed and flexibility, CDC turned to the foundation for a number of issues… all the way from getting boots on the ground, having flexible funding, to be able to hire. And so, we were actually very instrumental in what’s known as the Western surge, which turned around the outbreak in Sierra Leone, as one example.
We also were early in on the vaccine trial because government funding wasn’t available, but they were ready to go, and you’ve got a lot of cases and they needed to move forward on that. Very happy to be able to do that. And then government funding typically will follow what we maybe have been… more of the fire starter.
Zika – we’re very proud of the work that we did during Zika, particularly in Puerto Rico where we stepped in to help, and… I could go on and on because we’ve got a lot of notable achievements with over 1,200 programs that we’ve been involved in since our inception.
Denver: I headed up the fundraising campaign for The Statue of Liberty – Ellis Island Foundation, and we had a partnership with the Department of Interior and The Park Service. And it’s funny you say that. It was the exact same thing.
So when we started, the Park Service and DOI was going to do all the construction on the Statue and on Ellis, but they realized with government regulations, they couldn’t move fast enough, and they turned it over to us. So there’s a dynamic there that is really, really interesting, that really helps the public at the end of the day, and people don’t even appreciate the vital role that you fill.
You talked about emergency response, so let’s talk about an emergency. What is the CDC Foundation’s role in COVID-19?
Dr. Judy: Oh boy. So we have been busy since January of 2020. It’s an understatement. It’s been the fastest growth of the foundation and the most comprehensive work that we’ve done in our history.
So CDC activates their emergency operations center. Early in the response, if everybody will remember, in January of 2020, within a week, we had activated our emergency response fund to help philanthropy understand how big this was going to be and begin to request donations to come in and help us. Very thankful for the response.
We had a tremendous response from donors all the way from individuals to foundations…and from businesses, and that allowed us to do everything from the front end of the pandemic when we were really needed because government funding hadn’t caught up yet. Everybody’s scrambling. We got involved with personal protective equipment. We sourced PPE from China and helped a number of states and a number of healthcare settings and public health on the front lines. We helped the central workers. We funded a number of community-based organizations.
And when we do our work, we look to connect the health departments with whoever that partner on the ground is, so that we’re in alignment. What are the priorities of the health department and public health? And then how do we activate that across the community? So that’s been really rich work. A lot of work focused on health equity, working with the homeless community’s quarantine. If you remember the need for quarantine and isolation, and folks needed medical devices, so we stepped in on a number of those types of things.
And then we hired over a thousand field staff to help health departments, so with the surge staffing. To your point about we can move much faster – we can just get it done as a nonprofit. And so, we literally had CDC Foundation field staff in every state health department in the country – the six largest cities, tribes, territories. So that was really rewarding work.
And then community-based organizations is our current focus where we’re funding– I think we’re funding about 149 across the country now, and we do webinars and technical assistance. And that’s really for the vaccine effort. It’s a ground game now to get the vaccines and be able to answer folks’ questions that they deserve to have answered if they have any–
Denver: That’s a pretty big answer, but that’s a heck of a mandate that you had.
Let me pick up on a couple of things you said, the homeless, and I was really interested in how you were focusing on sanitation services. Tell us a little bit more about that.
Dr. Judy: We had a number of requests from communities around sanitation, all the way from like funding hand-washing stations out in the community or in parks, so that the homeless could acquire those. We also were asked to help fund and create opportunities for the homeless that were in shelters that were too concentrated, so they needed to be able to spread them out for quarantine and to decrease the risk of infection. So, lots of work on that.
Denver: Fantastic. And hats off! You just were awarded, I think, the WebMD 2021 Frontline Champions Health Heroes award?
Dr. Judy: We were. And what I love about that award is we received that award on behalf of all essential workers across the United States. So, we really are just a conduit. We were a supporter. The award really is to recognize all the essential workers that kept going to work and for keeping our society running during the pandemic.
Denver: Great stuff, Judy.
And you talked about the fundraising. You guys raised $173 million specifically for COVID-19 response. That is extraordinary. How were you able to do that?
Dr. Judy: Well, I have to tell you – we went with all channels. I mean, this was all in, and we ended up doing some things that we had never done before. So we set up and had a website, and individuals donated. I have to tell you – we’ve never before had children doing fundraising.
Denver: Oh, that’s great.
Dr. Judy: Oh, my goodness. Some of them did music and art and all kinds of things. So, it was all the way from individual fundraising. We had a number of employers that did employee giving where individual employees could donate to us but kind of in the framework of their business. A number of foundations, of course, stepped in. So, it was just– it was an all-in effort. We did a little of everything, even cause marketing, which we had never done before.
Denver: Oh, my goodness! Who did you do that with?
Dr. Judy: So there were a number of retailers that would do cause marketing. One I’ll mention is Igloo. Last summer, of course, everybody was trying to get outdoors, and there was demand for that. And so, Igloo would give us a portion of each of the coolers that were sold to come into our COVID response.
Denver: I do remember Nordstrom, too, I think, did something, if I recall it correctly.
Dr. Judy: And Nordstrom did that… right at checkout. That was one of them. They’re actually almost too many to count.
Denver: That is so good. And being a football fan, if my memory serves me correct, I think in 2020, they did a Draft-A-Thon, and you were one of the beneficiaries of that. So that wasn’t through research. That was just watching television on my part.
Dr. Judy: That’s right. Well, and actually to that point–thanks for reminding me–we were so appreciative of the support from the NFL. And they did another Draft-A-Thon in 2021 as well.
There was a golf tournament as an example. Callaway and others helped support us. There were a number of those kinds of events. There was a Saturday Night Seder that folks from Broadway put together and helped raise money for us. It was all of society rising up to help with this pandemic.
Denver: Even the TikTok crowd, I think, got involved, so it’s really amazing.
Dr. Judy: They did.
Denver: Do you think that that’s going to change your fundraising profile going forward? Do you think that this was a one-off? Or do you think this is going to be sort of embedded in the way that you think about generating revenue in the future?
Dr. Judy: Well, I certainly hope that going forward, that donors and businesses and all of those… everyone involved realizes the power of public health, the importance of public health on all of our lives every day. We at the CDC Foundation certainly will continue to pursue these broad opportunities for fundraising.
And then I think for us… the sweet spot for us is that when we bring in philanthropic funding, we’re matching that up and leveraging it against what the government’s investing in. And I have to tell you, my team will tell you – I don’t like waste. I like to be very efficient, and I love a good strategy. And so, that’s the approach that we take.
Denver: Well, as you say, you have a little bit more freedom to move with the dollars that come in here, and the government sometimes has their hands tied a little bit more, and therefore you can help them get things started or fill in the gaps.
Judy, the organization has programs across the world. Some 222 programs, you’re in 142 countries. It’s a massive operation. How does a foundation balance all of that when you have a crisis like COVID-19 here at home?
Dr. Judy: Terrific question. We actually have done some redesigning and restructuring inside the foundation over the last five years. I know when I came in as CEO and realized how broad the work was… we had, as an example, our program office was under one vice president. And so, we started dividing and conquering. And so, we’ve got a vice president of infectious disease, non-infectious disease, and they do not get involved with the emergency response.
We created an emergency response unit that has grown considerably, as you can imagine. And all emergencies go through that unit to be able to preserve the attention on all of the other work that we’re doing.
We do need to strengthen public health in this country, and we need to do it in a sustainable fashion. Only about 3%, I believe, of funding goes to public health versus healthcare.
Denver: That’s good. I had the CEO of the Against Malaria Foundation on the other day, and he said working with all the ministries in Africa, the first thing they did when COVID hit was that they were not going to take a step back on malaria. Because they recognize that sometimes we get so focused on–I don’t want to call it the shiny object–but what’s in the news, that we take our eye off the ball, though the consequences of that can be devastating.
We spend–I don’t know what it is–maybe some $3 trillion in this country on healthcare. How do we strengthen our nation’s public health system to be better prepared for future threats and also to assure a greater equity?
Dr. Judy: It’s a terrific question, and it’s one that keeps me up at night because we do need to strengthen public health in this country, and we need to do it in a sustainable fashion. Only about 3%, I believe, of funding goes to public health versus healthcare. One of the things that we need is greater integration of public health and particularly primary care in this country. It’s been something that we’ve had a vision for. It’s been talked about. Efforts have been made. But that’s something I hope, in the aftermath of the pandemic, that we see.
But in terms of building the public health system, besides sustainable funding, we’ve got to build our workforce. And the workforce needs new talent, new skills. And data modernization is something that we must have in public health going forward to be strong and to hopefully prevent the next pandemic. That’s really the quest – is to prevent it. So those are the major areas that we need to do.
And then inspiring young folks to come into public health, which is happening. With all the folks that we hired in the health department, some of those folks were right out of college and had never thought about public health. And now, they’re going into MPH schools. I think our schools of public health need to retool and train for the future. It goes beyond some of the technical skills. It goes into partnership and the ability to be strategic, and then work with the partners in the community, work with health systems, as I mentioned. We’re all part of public health.
Denver: And it’s interesting what you said about the primary healthcare system. Because from what I understand, in almost every other country, it’s the center of the healthcare system, and it’s kind of a shadow of what it was here in America. Would that be right?
Dr. Judy: Yes. That’s right. We’ve got a lot to learn, I think, from other countries, honestly, with the integration of medicine and public health. I’m a primary care physician originally in the early part of my career, so I’m pretty passionate about this intersection, for sure.
Denver: How’s that change been in your career? Doing that and now doing this? That’s a really interesting switch. And it’s a great background to bring to this job, but I’m just wondering whether you had to sort of develop new skill sets as you go along.
Dr. Judy: Absolutely. So, I am the classic lifetime learner. I feel like I’m constantly in school, and every day is a new opportunity to learn a new skill. So I’ve learned a ton since I’ve been at the foundation regarding public-private partnerships, how businesses think – that’s really important.
When I was at CDC, it was fantastic to be able to understand how federal government works. And as a state health officer, I learned state government having been in hospital systems. And so, I think bringing all of that to this job has brought me to a moment in time that I feel like I’m using everything that I’ve ever learned.
CDC Foundation, in some ways, if we make an investment, others will follow. We’re, in some ways, we’re like a good housekeeping seal of approval.
Denver: And you’re leveraging it now. Whereas before you were helping a family or an individual, now there is a system, and therefore the impact can be profound.
So, Judy, I was speaking to the CEO of the Komen Foundation the other day, the breast cancer organization, and she said that they had made more decisions in the past year than in the previous 15 years taken together. And boy, so many other people have gone down that same road, and these decisions have not been easy ones.
What would you say has been the most difficult decision that you’ve had to make during this crisis? And how do you approach making those kinds of decisions?
Dr. Judy: Well, what a wonderful question. So, I’ve had a lot. I would agree with Komen. We’ve probably made more decisions, and we certainly had the greatest growth in the foundation and complexity than we’ve ever had.
So one of the areas that happened during this is, because of the influx of donations early on, we were positioned to be able to make funding decisions. And we wanted to be quick. We’re in the middle of a pandemic. I set a goal that we would have, at any given time, at least 90% of funding come in the door would have been obligated or out the door, so we really kept moving. I believe an emergency response is, in fact, an emergency. And we have such a vantage point at the foundation to know what’s happening across the system, so I believe we can make strategic decisions.
But given that and given all the donations, as you can imagine, there were more demands and more requests upon us than we had money at any given time. So, one of the hard decisions was: Where do we invest with all the requests that were coming our way? And that we had a team, we have a committee that makes that decision, but I spearheaded a lot of the background work on that.
So, example, investing in data systems. Early on, we were being asked to invest in a lot of data systems. There was one that we made a final decision on in particular, but before making that decision, which was a hard decision, I did a lot of investigation. I made a lot of phone calls. I talked to a lot of experts. And we did that throughout the pandemic. Any funding decision, we’d want to make sure that we understood the ground truth, knew how the partners felt about it, and…were we making a strategic investment? Because one of the things we learned, CDC Foundation, in some ways, if we make an investment, others will follow. We’re, in some ways, we’re like a good housekeeping seal of approval.
Denver: Yes. I was going to say that – the good housekeeping seal of approval.
Dr. Judy: So we take that seriously. We had to be very deliberate. So, as an example, we did invest early on in something called Sara Alert. And then that ended up going on to being picked up by the government, CDC-funded. It went to scale. Over 700 health departments have used it. It was a technology that really enabled being able to manage folks in quarantine and isolation. So, that’s one small example of a lot.
And then I would say the second big decision we had to make was when we were called upon to hire so many staff and help build the CDC Foundation field staff because that was a sea change for us as a nonprofit. And the way we approached it is I pulled together my team, and I had them deliberate and then sleep on it, come back, tell me what you’re thinking, go sleep on it again. We took a few days, and then we all came back and said it’s the right thing to do.
Denver: I do that sometimes when I write, and I write some really brilliant stuff. And then I come back a couple of days, and I say, “This is garbage.” You know what I mean? “What was I thinking? Thank goodness I didn’t send it.”
So, a couple of things that you just said there that captured my thoughts was– one is the humility, that in looking at these other systems and things, you come in from a place where you recognize you don’t know anything sometimes. You wake up with that. And it’s that mindset that really gets you to dig in and to be curious and ask a lot of people. That’s really interesting.
And the second thing is scaling. You really had to scale. What did you find out about that? Because you not only scaled with this influx of money, you scaled with this influx of people, and you did it in midair.
Dr. Judy: That’s a great way– my team would tell you. They were definitely in midair when we did this. But I have to tell you what a fabulous experience on the other side we have had in the stories of what the field staff had been involved in, and some of them are really up close and personal.
As an example, some nurses that we hired in Alaska sent us photos of where they were doing testing. And at the testing site, here comes a moose with her. We had a team in American Samoa that helped folks repatriate. They couldn’t get back after the quarantines and such. The stories around the country have just been fabulous.
And then the–I don’t know–the expertise and the drive, and the… there’s just been a lot of passion with the folks that we’ve been able to hire because they wanted to make a difference during this pandemic.
Denver: And getting back to the moose, too. I think the other thing that I’ve heard from a lot of leaders, too, that’s really distinctive, is that despite the seriousness of all that happens, you really need to keep a sense of humor, you know? And sometimes people don’t think that. This is grave, we know, but you have to be able to laugh a little bit because that’s what fuels the energy to get you to face another day.
Dr. Judy: Absolutely. I couldn’t agree more.
My real hope is this integration of medicine and public health in a really meaningful way so that we can approach health in this country much more systematically. The silos don’t serve us well.
Denver: Finally, Judy. What do you believe the impact of COVID will be on the future of healthcare?
Dr. Judy: Well, for certain, when we look at healthcare, there’s a sea change in the acceleration of things like telehealth, telemedicine, which is also going to impact both healthcare and public health. So, I think that’s certainly here to stay.
I think technology has been driven. In any crisis, it’s also a time of innovation, and there has been innovation and people have leaned in. So, I think that we will see on the other side some great things come from this. Distant learning. We’ve all realized we can do it. So that’s going to be with us, going forward.
But my real hope, on the other side, is this integration of medicine and public health in a really meaningful way so that we can approach health in this country much more systematically. The silos don’t serve us well.
Denver: For sure. If listeners want to learn more about the CDC Foundation, tell us about your website, what’s on it, and maybe what they can do to be one of those individuals that help support your work.
Dr. Judy: Absolutely. Well, if you come to our website at cdcfoundation.org, you will find a lot about our programs. So you can dive deeply if you have interest in… whether it’s infectious disease, maternal health, what we’ve done with the COVID response. We have numerous stories on the website about what we’ve done. And so, it’s a pretty in-depth website.
For folks that would like to partner with us, obviously, we’d love for you to become a donor. We welcome all donors of all means, but we also welcome partnerships. And this can be all the way from local levels…. We had some donors as an example that wanted to fund their local health department or the work in their community. We do a lot of place-based work, and we leverage what CDC is bringing. So everything we do, we bring CDC along. We’ve got that systems approach.
So what I promise folks, if they’d like to partner on projects or just have a conversation with us, we’re happy to have those discussions. And my promise is that we will be good stewards and leverage any resources that might come our way.
Denver: I’m sure you will. I know what’s wonderful about those place-based efforts is that the ones that really, really work well, you can share it with other places.
Dr. Judy: That’s right. We love the bright spots, and we’d love to share.
Denver: Well, thanks so much for taking the time to be here today, Judy. It was a such a pleasure to have you on the program.
Dr. Judy: Well, thanks for having me. Wonderful time.
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