TYPOS corrected on Mar 10, 2016 — UPDATE 3 - Response from the CDC to Ethics Complaint Greetings from Jenna, Early this morning I posted my response to the HHS and one of our petition supporters kindly pointed out that I had made 3 typos. Thank you very much – such feedback is welcome! I have no editorial support and cannot always see my own typos. Here again is the edited Update 3 – On March 9, 2016 I received and response from a legal division at Health and Human Services (HHS) for the ethics complaint I filed on March 7, 2016 (see UPDATE 2). The response came with a warning that it could not be shared for various reasons and so I will avoid that trap. However, I will share my response to their response. Please see below. Subject: Appearance of preferential treatment by CDC/NCEZID/DVBD/BDB in violation of federal ethics statutes and transparency concerns Good evening XXXXX, I hope you are well. I appreciate your acknowledgement of my two correspondences dated February 5, 2016 and March 7, 2016 regarding the appearance of preferential treatment for the Infectious Disease Society of America by CDC/NCEZID/DVBD/BDB. I am encouraged to know that your professional legal expertise was applied to the review of these two correspondences and that this resulted in their being forwarded to the appropriate office within the Department for further action. In order to streamline and focus my communications on this matter, I would appreciate your providing me the contact information of this appropriate office and the name of the person(s) who is responsible for further action. Also, please confirm as to whether this office has investigative authority regarding ethics complaints. While I have your attention, please let me know where I should sent my concerns regarding the lack of transparency surrounding the Lyme Corps program. As stated in my March 7, 2016 correspondence I have assessed and evaluated numerous US federal government programs. I have also worked on classified federal programs and publications. When I worked on non-classified programs funded by the U.S. Agency for International Development, the U.S. Department of Justice and the U.S. Department of Agriculture, I found accessing general information about active federal programs to be straightforward. This general information is, by law, accessible to all members of the public. General information includes: the program description and what it plans to accomplish, the geographic areas where the program is being implemented, when activities will be implemented, annual and quarterly reports, assessments and evaluations of the program, the annual funding and overall budget, the names of partner institutions and the numbers of intended clients or beneficiaries. The CDC Lyme Corps is an active non-classified program; its implementation began in 2013 and it appears to be on-going. However, unlike most CDC public outreach programs, Lyme Corps has no public reference links on the CDC website. In January 2016, I called the Division of Vector-Borne Diseases (DVBD) as a member of the general public to make general inquiries. The DVBD staff called, including Lyme Corps epidemiologist Cristina Nelson, did not share any information about Lyme Corps. Nelson did ask me who I was and what organization I represented. One person asked I submit a written request from my affiliated institution to gain this general information. It is highly unusual for the DVBD to demand a formalized written request for general program information. As we both know, there are circumstances where information is restricted. For example, information is highly controlled when government activities are classified. Activities can have differing levels of classification and are classified for a number of reasons. There are stringent rules that govern public access to information about classified federal programs and publications. However, there are also stringent rules that govern public access to information about non-classified federal programs and publications. Lyme Corps is not a classified program. Lyme Corps is a public outreach program that is supposed to educate health care providers and the public about Lyme disease. As such, general information about an active non-classified program does not require a Freedom of Information Act (FOIA) request or depend upon giving personal information such as institutional affiliations. Such profiling is absolutely irrelevant for public access to general program information. Please note, I have found only one CDC web link to the Lyme Corps program and that is a Lyme Corps poster from the 2014 Atlanta, GA Conference Health Communication/Marketing Conference. See link https://nphic.confex.com/cdc/nphic14/webprogram/Paper35413.html There are no public CDC links to the Lyme Corps programs implemented at John Hopkins University (2014), University of Vermont (2014), University of Maryland Baltimore (2015) or James Madison University and University of Virginia (2015). These Lyme Corps activities were discovered by broad web searches. For a truly odd experience, I suggest you web search: Nursery plant sale advertising flyer - Johns Hopkins This is the website where I found the Lyme Corps poster seen at Johns Hopkins University. I suggest you then web search: http://www.jhsph.edu/offices-and-services/practice-and-training/news-and-events/_documents/CDCLymeCorpsFlyer_09-29-2014_FINAL.pdf and you will see this poster has a left corner tag that says Nursery plant sale advertising flyer. In addition, the Lyme epidemic is not only devastating lives, it is very costly. A 2015 publication in the Public Library of Science estimated that medical costs generated by Lyme, over a one year time period, to be an additional $712 million to $1.3 billion a year. [Ref 1] Survey findings in the 2011 Health Policy Journal publication found that “a quarter of [Lyme patients] respondents had been on public support or received disability benefits due to Lyme disease symptoms.” [Ref 2] An April 2006 publication in Emerging Infectious Diseases showed the direct and indirect costs of Lyme disease averages $8,172 per patient, or $10,769 when adjusted for inflation. [Ref 3] The annual costs of 300,000 new cases per year can be calculated at more than $3.2 billion. The amount of tax money supporting Lyme Corps should be readily accessible to the public. Why would any public health communication program have such restricted access to general program information? For example, information on the CDC public health communications programs for the vector-borne Zika virus and West Nile Virus are widely promoted via the CDC website, social media and traditional media. Altogether, these many transparency irregularities make Lyme Corps appear secretive. Therefore, I would very much appreciate you directing me to the proper office and persons who address such transparency issues. As I understand the law and the spirit of open government, Lyme Corps does not conform to federal standards for transparency of non-classified activities. I look forward to your response. Please contact me should you have any questions or if I can be of further assistance. Thank you very much, Jenna Ref 1 - Health care costs, utilization and patterns of care following Lyme disease 2015 written by Emily Adrion, MSc; John Aucott, MD; Klaus Lemke, PhD; and Jonathan P. Weiner, DrPH - Johns Hopkins Bloomberg School of Public Health Ref 2- Healthcare access and burden of care for patients with Lyme disease: A large United States survey, Health Policy Journal September 2011 authors Lorraine Johnson, Alexandra Aylward, Raphael B. Stricker Volume 102, Issue 1, Pages 64–September Ref 3- Economic Impact of Lyme Disease 2006 Xinzhi Zhang, Martin I. Meltzer, César A. Peña, Annette B. Hopkins, Lane Wroth, and Alan D. Fix