CDC: Working to Stop the Cough Heard Around the World

CDC Director Dr. Tom Frieden on Tuesday warned of a forming perfect storm—new infectious diseases, drug-resistant bacteria and diseases that could be used as weapons—that poses increased risks to the United States’ health security. At the same time, he was optimistic about a number of opportunities that have the potential to dramatically improve public health outcomes, stating that “today public health is more needed than ever and has more potential than ever.”

In his remarks at The National Press Club, entitled “The Cough Heard Round The World,” Dr. Frieden described CDC’s work in simple terms. “Our first responsibility is keeping people safe,” he said. “It’s not rocket science. First, figure out what the problems are. Second, figure out what the solutions are. Third, implement those solutions. Fourth, see if they are working and… then monitor, tweak and adjust them.”

Still, he acknowledged the complex challenges faced by public health providers in this country and around the world. For instance, in the area of emerging diseases, Dr. Frieden mentioned the outbreak potential of H7N9 influenza in China and Middle East Respiratory Syndrome. To help address these challenges, he described how CDC works with countries across the globe, using China as a case in point, to protect the citizens, businesses and economy of the United States.

Dr. Frieden said that Severe Acute Respiratory Syndrome (SARS) cost the world over $30 billion in 2003, in part because China was slow to respond to the outbreak and did not share information that would have aided an international response. Contrast that experience with China in 2013 after a decade of trust and capacity building with CDC and other partners. From the first hours after the Chinese identified the H7N9 organism, Dr. Frieden said that they have been transparent, including rapidly posting the organism’s genome online. As a result of China’s rapid collaboration, CDC began work on a vaccine, which is now entering clinical trials to determine effectiveness.

Looking ahead, Dr. Frieden believes there are more opportunities to advance public health issues. For example, he argued for giving CDC the tools needed to do its job—including equipping CDC with advanced molecular detection (AMD) technology, which can rapidly map the genome of microbes. AMD is currently in the President’s 2014 proposed budget, but that budget has yet to be approved.

He commented on the technology’s potential, saying, “When I started at CDC as an epidemic intelligence service officer, it took months to sequence a tiny part of a genome and then months more to try to interpret the massive amount of data that we got. Now, that same type of test can be done with a tiny chip in just three hours.”

As Dr. Frieden noted, CDC is concerned not only with outbreaks but also with addressing chronic public health issues—and preventing them—through improvements in healthcare. “For the next decade, the leading challenge for public health is to strengthen the collaboration between healthcare and public health,” he said. While focusing on expanding healthcare coverage and reducing costs is vitally important, he added that it is also critical to increase the quality of healthcare and the impact of prevention to transform the nation’s health system.

Dr. Frieden acknowledged that there are those who believe public health is no longer as relevant nationally or internationally. He said, “Exhibit one for that mistaken belief is the fact that over the past four years about 46,000 jobs have been eliminated by state and local governments in public health departments. In state after state as budgets recover, those jobs are not yet being put back.”

To navigate the challenges of the perfect storm and seize upon the opportunities created by the collaboration of healthcare and public health, it is vital to have a strong public health infrastructure in place to detect, treat and prevent infectious and chronic diseases, even in a challenging budget environment.

Watch Dr. Frieden's Talk at The National Press Club on C-SPAN