Tom Frieden
The outbreak of the novel coronavirus in China and its spread around the world show how fragile public health systems can be, and how urgently all countries must step up to address infectious diseases and other health threats. Every country can save lives and money, and better support families and communities, by strengthening their capacity to find, stop, and prevent health threats of all types.
The United States and China have engaged in a productive and mutually beneficial collaboration on a wide range of public health issues for the past 30 years. In 2002, China created the Chinese Center for Disease Control and Prevention. In my eight years as director of the US Centers for Disease Control and Prevention, I had the honor of participating in a strategic partnership with the Chinese CDC and meeting at least annually with my Chinese colleagues. I have seen first-hand the dedication of the Chinese CDC leadership and staff.
Five key elements to address health issues
During my more than 30-year career in public health, I’ve learned that the most effective public health units at local, city, state/provincial, national, and global levels have five key components that enable them to address a wide range of health threats:
• Sufficient funding. Stable and assured funding is necessary. The US CDC is funded at $12 billion per year — approximately $40 per person, supporting more than 23,000 staff, more than a hundred world-class laboratories, programs in dozens of countries and extensive grants for public health programs in the US.
• Sufficient number and quality of staff to detect, investigate, stop, and prevent health threats.
State and local health departments in the US have more than 200,000 members of staff, and public health workers are experts in nearly every aspect of health promotion and disease prevention, from infectious diseases and environmental health to non-communicable diseases and injuries. Salary scales for top experts at the US CDC are above the usual allowed by the government.
• Close connections with other public health and healthcare entities. The essential importance of a national public health institute is not just providing reference laboratories and technical leadership, but also upgrading skills and capacities of subnational public health agencies. The US CDC does this by directly funding state and city health departments, and sending them embedded staff on long-term assignment. The US CDC is highly regarded by leading specialists and works closely with them in areas such as infection prevention in hospitals and establishment of clinical guidelines.
• Technical independence in the context of political support. As director of the US CDC, I briefed former president Barack Obama whenever needed, and had much freedom to act independently. The CDC’s technical expertise is respected both within and outside of government, both in the US and globally. Direct access to the highest levels of government gives US CDC authority and ensures that public health is prioritized at a national level.
• Effective communication. The US CDC communicates frequently and effectively with the public, doctors, the media and policymakers. It produces the Morbidity and Mortality Weekly Report, a weekly epidemiological digest widely respected as a definitive resource worldwide. In times of crisis, it follows the risk communication principle: “Be first, be right, be credible.” -The Daily Mail-China Daily news exchange item
