Top public health spots still unfilled

White House: Takes time to find top doctors/managers

President Bush hasn't nominated a replacement for former U.S. Surgeon General David Satcher, whose term ended earlier this month.

WASHINGTON (CNN) -- President Bush says last fall's anthrax attacks exposed weaknesses in America's public health system, and he has pledged billions in new spending to swiftly identify and treat victims, should there be another attack.

But even as the public health system is preparing to fight bioterrorism, the government's top health agencies are leaderless.

There are no directors of the Food and Drug Administration (FDA) or the National Institutes of Health (NIH).

There's no surgeon general -- Dr. David Satcher's term started in 1998 and ended this month. Dr. Kenneth Moritsugu is serving as Acting Surgeon General.

And this week, Dr. Jeffrey Koplan, head of the Centers for Disease Control and Prevention (CDC) -- the first line of national defense in fighting bioterrorism -- announced that he's resigning in April.

VIDEO Vacancies in top government medical agencies could be a weakness against bioterrorism. CNN's Major Garrett reports (February 23) Play video (QuickTime, Real or Windows Media)

These agencies are scheduled to receive more than $32 billion in tax dollars this year, and yet they have no firm leadership.

"Having a leadership vacuum is of very, very grave importance to the nation," says Dr. Mohammad Akhter, executive director of the American Public Health Association, "and we can't win this war with a leadership vacuum at the highest level of our government's medical system."

Top administration officials downplay the dangers and say they're moving to fill vacancies.

"The process is very slow," says Tommy Thompson, secretary of the Department of Health and Human Services.

"The White House wants to make sure they get the right person for the right job, and they're working diligently to make that happen, and I'm sure that these positions are going to be filled very quickly."

Public health advocates say they fear that too much time may already have been lost.

"Talk is cheap," Akhter says. "What this nation needs is action. You know, 14 months is a long time to keep these very critical positions vacant."

The White House says it takes time to find high-quality doctors who also are top-flight managers. But critics say top candidates are readily available, and argue the delays are unnecessarily jeopardizing the nation's ability to fight public health threats of all kinds.