and operations must be established, along with accountability for results.

  1. The secretary should ensure a more prominent and powerful role for the surgeon general, who, in addition to leading the Commissioned Corps, should be a strong advocate for the health of the American people and work actively to educate Americans on important health issues. The secretary should work with the President and Congress to establish a process for identifying surgeon general candidates for presidential appointment that gives high priority to qualifications and leadership, and Congress is strongly urged to consider a longer term for this office.

  2. The secretary should work with the President and Congress to establish a selection process for the department’s senior-level officials that protects the scientific and administrative integrity of major departmental units, promotes progress toward departmental goals, and is based primarily on the candidates’ qualifications and experience. Congress again is strongly urged to consider longer terms for some of these officials—especially the directors of NIH and CDC, and the commissioner of FDA—which would provide critical continuity in the nation’s public health and scientific endeavors.

  3. The President should make timely appointments and Congress should expedite the confirmation process for key HHS officials, including the secretary, deputy secretary, surgeon general, and the heads of FDA and NIH. Secretarial appointments, such as the director of CDC, should also be expedited.

  4. The secretary should ensure that all department health programs, including the reimbursement programs, reinforce public health priorities and strategies in order to provide a consistent framework for protecting the public from health risks, promoting health, preventing disease and disabil-

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