Name: Inside the CDC: Operational Leadership Under Pressure
Uploaded: 2026-06-02
Duration: 14 min 6 s

Running operations for one of the world's most complex public health organizations means making consequential decisions under constraints most industries never encounter. There are life-and-death stakes, regulatory complexities, relentless cost pressures, and more. Robin Bailey Jr., former COO of the CDC, shares what it takes to navigate this terrain: making tough calls when speed and accuracy matter equally, managing policy shifts and geopolitical realities, building teams, and leading with conviction when the mission is no less than building a strong and resilient healthcare system that protects the wellbeing of the American public at large. 

Robin Bailey Jr., former Chief Operating Officer, CDC
Moderator: Kristin Stoller, Editorial Director, Fortune; Co-Chair, Fortune COO Summit

Inside the CDC: Operational Leadership Under Pressure

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In 2021 during COVID post first Trump administration, what a time to start. What made you want to take that job at that time? Well, you know, I have been in federal service for a long period of time. I did about 39 years, but at the time I was at the IRS and I really wanted to be a part of trying to help at the CDC. And um when I applied for the job, one of my colleagues said to me, uh, you're jumping out of the frying pan into the fire. And um when I arrived there I kind of understood what she meant but I'm one of those that like to be on the court in the game and I really enjoyed the time that I was there even though it was a very stressful time. What would you say was the biggest challenge that you faced right away as COO then? I think the biggest challenge was really around the people, um, going in to see how hard they were working. They were very stressed, um, fatigued. In giving everything that they had. But the public scrutiny was such that everything you have isn't good enough and that was difficult so my objective really was to try to help them move through that trying to block the noise from external. And talking about all the things that we did right, recognizing that we made some mistakes, hm, and tell me how you spoke to your, your employee, both your employees and the public about the mistakes and how to move, move past them and get around that. Well, fortunately for us we had a wonderful director, Doctor Wilensky, who handled most of the external things, and she gave us really clear direction around what we need to do, but she took ownership of the mistakes that we made. And asked us to do better, and we really went into a mode of reflecting and also listening to the public in terms of what they were saying, our partners were saying, but what the uh the political atmosphere was, and that was really a big part of it too. When you're thinking you're you're doing OK and you feel like the people who should be supporting you are not really supporting you, that was really, really difficult, but we did accept the fact that we had some missteps and we really want to do better and we engaged the entire team in trying to make that happen. Excellent. Now I want to bring it back to the Current day, so you know, as we sit here, the CDC is facing a lot right now. They're responding to recently news, the, the multi-country hantav virus cluster traced to that cruise ship. Uh, a new Ebola outbreak is happening right now. Knowing what you know about, you know, how the CDC is staffed today, how it's run, are you worried? Should we be worried? And how are you thinking about it? Well, number one, the people there are above report approach, uh, relative to their skills. They are the best of this when you talk about public health. CDC is the mecca, if you will, of people who are in public health. That is the place you want to be if you go into public health. So I'm very, very confident in the skill sets that we have at CDC. In their ability to do this work however I am equally concerned about the number of cuts and things that happened most recently because we lost a lot of talent and a lot of the confusion associated with that many of the things that we put in place I'm not sure that they're operating in the same way I I know you saw in the news. News how many of the leaders resigned. So having that kind of expertise walk out the door having that understanding is difficult. However, I do believe in the workforce and what they will bring to the table to support us. Yeah, and I wanna talk about those cuts because the CDC lost nearly a quarter of its staff since January of 2025. Senator Kennedy is saying that the cuts will return the CDC to its core mission of tracking disease and investigating outbreaks. But from your seat as a person who ran that infrastructure, what do you think the future is? Is that true? Can they do that? You know, I don't really want to get into what how he's thinking about it, but, but I, but I do, I will say this, that the workforce that we had, we had about 13,000 individuals who were working at the CDC and they were highly engaged because CDC was shifting from being an organization that's kind of sitting back waiting for something to happen to move to an organization that was more responsive and the changes we made in our structure. As well as our systems and our processes we're on track to address. Now keep in mind CDC was preparing for this for 75 years. I mean it's been 100 years since we had a pandemic was preparing for this, and we recognized the things that we got wrong and we were on a track to correct those and I think that's one of the concerns I have about our current system. When you talk about an administration 4 years max 8 years, many times they don't want to adapt or take on the things that are working well, wanna do things different, and when you're talking about the protection of health in our lives, that's not something you take lightly. It's not like you just wanna change your mission and go in a different direction. It's really about making sure you stay true to all of that history. And making sure we keep those processes in place to make sure we can do our jobs. Absolutely. I'm gonna turn to the room in just a second for questions, but first, Robin, I'm hoping you can tell us, you know, as someone who operated during your own pandemic, during COVID, what is one lesson that you took from it that you would like to share with CEOs here that you think could also be relevant to, to their experience as well? I guess one of the most important things is operational excellence, um, without the right systems doesn't scale, so you have all these people who are really, really good at what they do, but if you don't have the right systems and processes in place to make sure that's scalable across, I mean when you think about the CDC at any given time. They're looking at a surveillance of disease across 196 countries and and billions of dollars in grants and um the partnerships they have with state and local to make sure what's happening and the goal is to make sure that we protect the homeland. And keep disease outside and working with various countries when we see something happen, we're there, you know, working in collaboration with WHO and others, which we're no longer doing at the moment, but Uh, I should say we're no longer do, we're not, we don't have the same partnership. I think there is some conversation happening there, but the bottom line is all of that, all of those systems working together really keep the world safe, not just the United States. We wanna make sure we keep it outside of our borders, and that was the way to really make that happen. Makes sense. Any questions from the room? OK, well, if you have one, raise your hand. I'll come back to you. But you know, last night, Robin, my, my dinner table, which was fabulous, shout out to everyone who's still, still here from there, um, but we talked about boards a lot and answering to a board, you know, private sector CEOOs answered to one CEO and the board. You answered to a lot of different bosses. You answered to a director, the HHS secretary, the White House, 50 state health departments. The list could go on here when all those different bodies disagreed. Whose call did you actually follow and how, how did you navigate that? At the end of the day we work for the administration and that's really where we get our direction from in order to make uh make uh some of the calls that we make, you know, both organizations when I was with the IRS as well as the CDC. It was supposed to be non-political. You don't have that engagement in there, but during COVID we started to see that kind of involvement really what what really makes it more difficult to be able to do the job, but that's really where the bottom line comes from is from, uh, the administration but the administration's also reacting to public outcry about various things, etc. and at one time I know when we first started with COVID. I recall being at the IRS and everything was about what does the CDC say? And after a period of time because of all the political elements and other things that happened then everyone's questioning what the CDC says but when you're talking about a country and you don't have a body in which you can turn to and get good advice and counsel, you have chaos. So it's really, really important that that organization continue to have its role of protecting health and improving lives. It's very, very complicated, but at the same time we need a body that we can go to and be able to get clarity and that was one of the things as we talked about CDC moving forward it was about being faster, clearer information so when the public receives information you can do something with it it's not in scientific speak. The coordination with the public, uh, whether that be state and local as well as our ability to execute and keep people safe. So those were the things that we were working toward to try to be much faster in terms of how we did that and the lessons we learned and I just hope that they are able to continue to do that because it's so important. I hope so. How do you block out that noise because you faced a your organization, not you personally, but the organization faced a lot of, of criticism. And when you're operating in that environment. How do you build trust and just keep on the path that you're doing? Well, I, I don't think you can do very much at all, uh, if you don't have trust. And so we were working really, really intensely while, um, Doctor Wilensky was out with the public and making the commitments. We were internally trying to build the trust to make sure that we could fulfill those commitments that she was making. And we did a lot of work. Um, the thing that was interesting that was different in this environment was, you know, we're talking to you here many times during this period of time I was talking to a screen because there was no one in the room, so trying to build that trust and you don't have the day to day engagement made it much more complicated than it otherwise would have been, but as we looked at our EBS scores. We were seeing that the trust was starting to come back and um We engaged the entire team, I think we had about 20 pat teams, we had over 160 action items that we were trying to work toward based on the feedback that we had received, and I think in October of 2024 we had completed uh 90% of those. So we were on a path where the people who do the work on a daily basis have their voice in there. And it was things that they believed in because they believed in the mission, so we could get that alignment around the culture and that love for the mission we would have something we could move forward with. So it's really kind of disheartening to see what happened with the CDC. And whether the work that we had spent so much time and effort in doing would really work when we're talking about a time like this. Yeah, that makes sense. You've also worked in the, the private sector as well. Is there a lesson from the private sector that you wish you could have, you know, or, a practice that you wish you could have put into the CDC and vice versa, one from the CDC that maybe you wish you could impart in the, the private sector today. Um, you know, whether it's internal to a government or external. You know I'm, I'm a people first, uh, mission always kind of person and it's really about the trust. And getting your organization and you know we talked a lot yesterday about um all that's happening with AI. And if you don't have the trust in your organization, the buy-in to make those things happen, I just don't think it's going to be as successful as it otherwise could be. And so I, I would just say, um, making sure that you have built the foundational pieces in your organization so when the storm comes you're prepared and that's one of the things that I found for us is we had not done that foundational work. In a real way. We had 10. Different centers who operated like they were individual centers as opposed to as an organization. And when you're talking about a time like the stress that we had during COVID, it doesn't work. Those structures, systems and processes have to be in place and the trust that when the time comes they will work has to be there and you have to follow that playbook. That makes sense now Robin, I wanna end here on, on one question. If you could go back in time and tell yourself the day before you started as CEO of the CDC one piece of advice, what would that be? Listen more talk less. Listen more talk less. Um, I, I think many times the solutions are in the room if we're willing. Yesterday we had an exercise with the blind with the blinders on. It was amazing. Shout out to Carr here in the front row, and seriously listen more, talk less I think is really something that's really important. So you're not judging in any way but really listening what people are saying, where they're coming from, so that you have the voices in the room that will help you see from a different perspective and you can make a more informed decision. That is great advice to end on. Thank you so much, Robin. Thank you.