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I have worked in a local county health department. I have worked in a state health department. I have worked at CDC, many of the people at the CDC, however smart they are, have never worked in a state or local health department. They've grown up, if you will, with the best academic training, [and] they've ended up at the CDC. They have expectations about state [and] local health department partners, but they have no experience working in those agencies and understanding the challenges and complexities that are there, and I think that perspective is badly needed.

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