Summary

The Public Health Service (PHS) conducts or supports national programs of health services delivery, disease prevention, health promotion, and biomedical research through eight PHS agencies. Because agencies' programs often address the same diseases or conditions, the potential exists for duplication of effort. Congressional concerns have also been raised about the expansion of funding for the Centers for Disease Control and Prevention (CDC), which rose from $587 million to about $1.5 billion between fiscal years 1987 and 1992. Concerns have likewise been raised that the scope of CDC's programs and activities today extends well beyond the agency's early focus on communicable disease. GAO found that no PHS agency was duplicating another agency's public health activities in the programs GAO reviewed. Also, CDC's programs were appropriate considering the agency's legislative authority and its history of prevention and control efforts regarding chronic diseases and other health conditions. Public health experts GAO consulted support CDC's activities.

GAO found that: (1) there were no duplicative efforts in the six program activities reviewed; (2) although some PHS agencies have programs that address the same disease or condition, none of the agencies conducted the same activity directed to the same target population; (3) PHS agencies have developed many coordination channels to share information, foster cooperation, and reduce work duplication; (4) CDC activities are consistent to its mission of preventing and controlling disease, injury, and disability; (5) CDC activities are supported by legislation, its history in preventing and controllinig diseases, its established relationships with states, and the views of public health experts; and (6) CDC has legislative authority to conduct or support diabetes, breast and cervical cancer, and intentional injury prevention programs.