To my colleagues in public health: Don’t despair.
I have heard your concerns: You have spent a lifetime trying to improve health only to have it dismantled, vaccines disparaged, the foundation of public health discouraged, leaders with no public health experience and no involvement in running large institutions appointed to run our trusted institutions.
Credit: contributed
Credit: contributed
So, what is the positive side?
First, everything you have done to protect children with vaccines, to gain knowledge by responding to Ebola and other outbreaks, every addition you have made to public health will continue. The children who have been vaccinated are protected, probably for life. Your efforts are not lost.
But second, I have known every director of the Centers for Disease Control and Prevention for the past 65 years. Each one took seriously the overwhelming responsibility of eliminating premature mortality, unnecessary morbidity and compromised life quality. David Weldon, President-elect Donald Trump’s pick for CDC director, will face that same heavy responsibility. We assume he will want to succeed, and he will depend on the CDC’s entire workforce to provide the best information and support, just as it has done for every director.
Third, Weldon is medically trained. He surely understands that vaccines are the very foundation of public health. With briefings from the most knowledgeable people in the world on vaccines and interactions with the Advisory Committee on Immunization Practices, he will learn that 3 million deaths each year are averted globally because of the smallpox vaccine, and another 3 million deaths are averted each year globally because of the measles vaccine.
I have no expectation that Robert F. Kennedy Jr., President-elect Donald Trump’s choice to lead the Department of Health and Human Services, has the capacity to evaluate scientific facts, so the CDC must take every opportunity to advise Weldon on public health, and especially vaccines, to support the remarkable effort of so many people who put public health above personal gain.
Fourth, though some would like to isolate politicians from public health issues, the simple truth is that all of our public health work is based on political decisions and politically reviewed appropriations. We absolutely need politicians in public health and to represent us in hearings. We need politicians who are motivated to invest themselves in healthy outcomes, not just appropriations. We need a combination of public health and politics, and Weldon can, if he chooses to, bring the public health world and the political world together.
So, my fellow public health workers, continue to give your best, using the finest science available, and never compromise your integrity. Science gets its power from being used, not simply existing. The public health community has a reputation for advancing consequential science and consequential compassion. You have been trained to solve tough problems. Accept this as a challenge, to unravel the epidemic of nonsense and to show that the health of Americans depends on coordinating with health workers globally. Weldon left medical school with the same burden placed on all physicians: “First, do no harm.” To leave the World Health Organization, as the first Trump administration tried to do, would be medical malpractice and no physician wants to be accused of that.
But it is not just the improvement of our health. There are also economic benefits. The United States recoups its investment in smallpox eradication every three months. Our savings thus far is180 times our investment (billions of dollars in the past 45 years) and will continue to grow forever. Our investment in the measles vaccine around the world spared us the expense of controlling measles outbreaks in this country. The reduction in measles vaccine use in other countries now requires continuous responses to measles importations. We need to constantly remind ourselves of our interdependence. We are in this together. Every place in the world is both local and global, therefore, wherever you are working in public health, it means you are working in global health, and we share the objective of global health equity.
We stand together in the interest of all people to advance public health. No administration can take that from us.
William H. Foege is a former director of the Centers for Disease Control and Prevention. He is a physician and epidemiologist whose global health contributions led to the eradication of smallpox in the late 1970s. He was awarded the Presidential Medal of Freedom in 2012.
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