Duke University’s Global Executive MBA programme is tailored for important people who want to become more important.

With students arriving with an average of 14 years work experience, the course appeals to ambitious young executives aiming for the big league.

But even among such high-flying company, there was one member of the class of 2002 whose job stood out for its weight of responsibility.

When Bill Gimson enrolled at Duke, he was director of financial management at the US Centers for Disease Control and Prevention (CDC), the government agency responsible for monitoring and tackling threats to public health.

Following graduation, he was promoted to the newly created position of chief operating officer of the CDC, placing him among its most senior executives.

Mr Gimson’s role gives him operational responsibility for an organisation with 8,500 employees and an annual budget of $8bn.

Other Duke graduates have gone on to jobs of a similar stature but what sets Mr Gimson apart is the critical importance of his position – not to company shareholders, but to the health of 300m US citizens.

In the event of a flu pandemic, a biological terrorist attack or any other public health crisis in the US, Mr Gimson would be at the heart of the CDC’s response.

He recalls the moment during his EMBA programme when the difference between his responsibilities and those of his private-sector colleagues became clear.

“We were talking about 95 per cent confidence as a target for business,” he explains. “My colleagues looked at me and said: ‘We want 100 per cent confidence from the CDC’.”

Mr Gimson is one of a growing number of public-sector executives equipped with EMBAs as government agencies face pressure to adopt private-sector standards of management and efficiency.

“We want to make the CDC an exemplar of good governance, marrying the best of the private sector with the best of the public sector,” he says.

Quality of management at US government agencies has faced heightened scrutiny since the Federal Emergency Management Agency (Fema) botched its response to Hurricane Katrina last year.

A large part of Mr Gimson’s job over recent months has involved preparing the CDC for the global flu pandemic that experts fear could evolve from the deadly strain of avian influenza currently active in large parts of Asia, Europe and Africa.

With its potential for millions of worldwide deaths and massive disruption to society and the economy, a flu pandemic would pose an immeasurably bigger challenge to the CDC than Katrina posed to Fema.

The CDC’s role would include developing a vaccine, monitoring the spread of the virus and advising the government on containment measures.

Mr Gimson admits that the agency is not yet fully prepared but he is confident it will cope should the worst happen.

“We are developing an operational plan, with 2,000 actionable tasks that we need to complete at the CDC, to be prepared. We are very methodically going through that process,” he says, without disclosing how many of the tasks have been completed.

“Being prepared is a process," he adds. "We are much better prepared than we were six months ago. We will be more prepared tomorrow than we are today. I’m an optimist. I know we will be ready.”

Preparing for bird flu is not the only challenge Mr Gimson has faced since graduation.

He has also played a central role in pushing through a far-reaching restructuring of the agency, aimed at making it more efficient and effective.

Barriers between departments have been broken down to enhance collaboration among scientists and reduce duplication.

But the shake-up has caused unrest among some employees who believe the result has been increased bureaucracy and loss of scientific depth.

An internal staff survey showed that the proportion of employees who believe the restructuring will have a positive impact has fallen from 58 per cent in 2003, when it was launched, to 35 per cent in 2005.

Mr Gimson is confident the reforms will improve performance, and believes employees and taxpayers will eventually see the benefits.

But he acknowledges that the process has been slow and painful.

“Government agencies are difficult to change,” he concedes. “I noticed during my MBA that people in the private sector are more inclined to see change as healthy.”

Mr Gimson joined the CDC straight from university in Milwaukee, where he studied political science.

He spent a decade in public health management roles in Chicago and New York, before being assigned to the US territory of Puerto Rico where he briefly served as acting assistant secretary of health.

His next stop was CDC headquarters in Atlanta and a series of increasingly senior roles in the finance and budget planning department.

Encouraged by the agency’s support for continuing education, he considered seeking a masters in public health.

But his bosses persuaded him that, after more than a decade in the field, there was little left for him to learn about public health.

Instead, they pushed him towards an EMBA, with a view to him becoming chief operating officer.

Duke, based in Durham, North Carolina, was the obvious choice – not just because of its stellar reputation, but also because of its proximity to Atlanta.

Another factor was the international nature of the Global Executive programme, which included residential periods in Europe (Frankfurt and Prague), Asia (Hong Kong and Beijing) and South America (Rio de Janeiro and Sao Paulo).

The course helped prepare Mr Gimson for his role managing the CDC's 300 expatriate and non-US employees in more than 45 countries.

CDC scientists are stationed around the globe to identify and help tackle diseases that pose a threat to North America.

“Many of these countries are on the frontline of global health issues so it was crucial for me to have a global perspective,” he says.

Typically, about 37 per cent of students on the Global Executive programme are non-US citizens.

Mr Gimson took leave to attend residential components of the course but otherwise continued to work full-time throughout its 18-month duration.

“It was hard work. I ended up working every night and weekend,” he recalls. “But it was exciting and the camaraderie and team spirit was very strong.”

He recommends an MBA to any public sector executive seeking to broaden their skills and learn from the private sector – provided they are careful not to lose sight of their public-service mission.

“Government is not business and it never can be,” he says. “We are held to a higher standard of transparency and accountability. Failure is not an option for the CDC.”