Every year, Centers for Disease Control and Prevention Director Tom Frieden rings in the new year with his “State of Public Health” address right here on APHA’s Public Health Newswire. His fourth annual update to the public health community worldwide once again recaps the biggest stories of 2015 and lets us know our greatest challenges and opportunities in 2016, from climate change to prescription drug overdose to antibiotic resistance — and much, much more.
One week before the president’s State of the Union address hits the airwaves, we’re proud to bring you the “State of Public Health 2016” with Dr. Frieden. Enjoy!
Q: What are CDC’s greatest opportunities and challenges for 2016?
A: CDC and our state, tribal, local and global partners have enormous challenges in the coming year.
- We need to completely extinguish Ebola in West Africa, eradicate polio in Pakistan and Afghanistan, and accelerate the work of strengthening public health infrastructure in every country so that the world will be better protected from the next threat.
- We must find and stop outbreaks of drug-resistant organisms rapidly and protect antibiotics by greatly improving their rational use among both humans and feed animals.
- We have to reverse the tragic and devastating opioid epidemic, particularly through improved prescribing practices for pain and addiction, and working with law enforcement to reduce the supply (and thus increase the cost) of illicit opioids.
- We have to double down on efforts to prevent our two leading killers – cardiovascular disease and cancer – by intensifying implementation of comprehensive tobacco control and making even more progress in our Million Hearts campaign.
We are under pressure to keep effective programs from becoming victims of their own success. As public health historian John Duffy noted: “Encountering apathy, ignorance, and avarice is the lot of all conscientious health officers. As preventive measures in the health area are more successful, the public is less inclined to support the programs which ensure this success.”
Thanks to the Tips from Former Smokers campaign and other tobacco control efforts, for example, fewer Americans smoke than ever before. Unfortunately, this success has led to complacency. Funding for the Tips campaign is threatened, even though it is an extremely cost-effective program that saves at least 16,000 lives each year.
Even the most successful public health programs require constant evaluation, innovation, and improvement. The progress we achieve builds on itself to create new opportunities to improve the nation’s health and reduce disparities.
Q: Last year’s CDC budget increased activities to prevent and combat antibiotic resistance, prescription drug overdose, global health security and laboratory safety and quality. How has CDC bolstered its attention to each of these concerns?
A: Antibiotic resistance may be the single most important infectious disease threat of our time. But we can delay, and sometimes even reverse, the spread of antibiotic resistance by becoming better stewards of these essential life-saving medications. Last June, the Administration proposed critically needed investments for an aggressive, coordinated approach that — if implemented — could prevent thousands of antibiotic-resistant infections and deaths and save billions of dollars in medical costs.
Last year, prescription opioid overdoses killed nearly 19,000 Americans, an increase of 16 percent in just one year. CDC supports states to optimize prescription-drug monitoring programs, take advantage of new Medicaid- and insurer-benefit strategies, and develop policies to improve clinical practice. Our FY2014 pilot program helped five states fight prescription drug overdose and is now set to expand to all 50 states. New opioid prescribing guidelines will help doctors and patients balance the substantial risks of addiction and death with the unproven benefits for chronic, non-cancer pain and increase availability and use of safer and equally effective treatment options.
Global health security protects Americans’ health by stopping diseases abroad so we don’t have to stop them here. Over the next five years, we and our more than 50 international partners will provide at least 30 nations — home to more than 4 billion people — with the tools they need to prevent avoidable epidemics, detect outbreaks early, and respond rapidly to disease threats before they spread.
The goal of all CDC laboratory programs is to keep America healthy, safe, and secure using the highest quality science. We strive to be the safest laboratories anywhere, and are fortunate to have one of the world’s leading laboratory experts, Dr. Steve Monroe, as our new Associate Director for Laboratory Science and Safety. We have already made progress making our labs the model for scientific excellence and safety.
Q: Thanks in large part to CDC’s largest and most intensive response in its history, the year saw the epidemic end in Sierra Leone and Liberia, but as you told us last year, “Our goal isn’t just to get to zero, but to stay at zero.” How are CDC and global health workers doing in this regard, and how close are we to seeing no cases worldwide?
A: By the time this is published in early January, all of West Africa may well be free of Ebola virus transmission according to World Health Organization standards. But that doesn’t mean our mission is over. We’ve helped establish systems in Guinea, Liberia, and Sierra Leone to rapidly detect and respond to any new Ebola outbreaks. Many CDC experts continue to be deployed to the region to strengthen local capacity and put an end to the worst Ebola epidemic in history, and our new offices in these countries will work to strengthen public health capacity to stop many health threats.
Q: The World Health Organization has said that climate change is the greatest threat to global health in the 21st century. What do you feel is the appropriate public health response moving forward?
A: CDC’s Climate and Health program has worked for many years to help states prepare for specific health impacts of climate change such as increased air pollution, extremes in weather, and faster spread of food and waterborne diseases. CDC scientists warned the nation of the increased threat of vector-borne diseases, such as dengue and chikungunya, which are now seen in areas they were never present before. CDC’s Building Resilience Against Climate Effects (BRACE) framework is helping health officials prepare for climate change, and our Climate Ready States and Cities Initiative is funding 16 states and two cities to identify likely climate impacts and associated health threats.
Q: This year APHA launched its Generation Public Health campaign to include everyone and everything that impacts health — from housing, education and income to community design, transportation and our environment. How can CDC, APHA and our peers in public health tap into these sectors to create the healthiest nation in one generation?
A: Generation Public Health builds on a key concept: every aspect of business, government, education, and communication involves health at some level. Partnerships with diverse sectors – when done openly and adhering to scientific principles – can result in effective, evidence-based programs that improve health. A “health in all policies” approach recognizes this interconnectedness and the synergies that can be achieved when all segments of society work together.