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January 13, 2009
A True Public Servant
In this final week of the Bush Administration, many long-serving public officials are wrapping up unfinished business and packing up their belongings, it is only fitting to pay tribute to one of these dedicated administrators, Dr. Julie Gerberding, director of the Centers for Disease Control.
I’ve had the privilege of working with Dr. Gerberding because I have been on the board of the CDC Foundation—a public private partnership -- for the past seven years.
Dr. Gerberding visited our New York office yesterday and discussed the state of global health with some of our staff. She reflected on her tenure, noting that she was appointed just in time to manage the anthrax scare (remember the envelopes mailed anonymously to top NY based media such as NBC News and elected representatives) and the SARS epidemic that started in China. The SARS epidemic, in particular, was a warning bell to the CDC that the US faces health threats originating from the around the world, and not just within its borders. She had to reorganize the CDC to cope with terrorist activities in the wake of 9/11. As the “Dr. Mom” of American health care, she has travelled relentlessly to investigate possible epidemics and to invest resources in disease prevention, particularly in the fight against HIV AIDS.
Here are a few of her observations:
1) The most effective approach to public health is to build capacity from the ground up, versus top-town. In Ethiopia, the health minister has created a health extension worker program, designed to provide basic health services. Each of the health workers—regular women hired in each village—purpose is to create “healthy homes” in the poorest villages in the world. They teach villagers how to ventilate the smoke from cooking or heating to the outdoors to reduce lung disease. Latrines are set up outdoors, with separate facilities for boys and girls, so that the girls can continue to go to school after beginning menstruation. They educate people about hand washing and using of bed nets to prevent malaria. The US Government invests in technical assistance, such as a rapid HIV testing kit and a few staff in the health ministry to train these health workers.
2) The broader availability of anti-retroviral drugs in Africa is simply buying time because only one in five with HIV gets drug treatment and transmission permission is insufficient. “We are not shutting off the transmission of AIDS,” she said. “We are simply buying time, in hopes we can develop a vaccine. The problem is worsening because resources are being redirected with the emergence of drug resistant tuberculosis and the onset of obesity.”
3) NGOs, such as Catholic Relief Services, offer very valuable financial support for micro-businesses and creating employment. Dr. Gerberding related a story of an older woman who has founded a small bakery between two platinum mines in South Africa. When Dr. Gerberding asked about the recipe, she overheard the owner on her cell phone saying, “There’s a crazy American woman here. She does not even know how to bake bread!”
4) There is real suspicion of American motives. On a recent trip to Eritrea to investigate an outbreak of liver failure possibly tied to consumption of a plant toxin by goats (goat herding is the #1 local business), she found the villagers wondering why an American agency cared about solving the problem. “Do we have their best interests at heart is the real question,” she said.
5) There is low-hanging fruit in health care reform in the US. She identified the value of investment in anti-smoking and obesity. “Health costs will not rise as quickly if we build bike paths, offer good playgrounds in schools and continue the fight against smoking,” she noted. We are under-funding state health departments, with the number of employees down 17% in the past few years. She suggested that as part of the fiscal stimulus, there be consideration given to building new community health centers and modern public health departments.
Dr. Gerberding, who will continue to speak out on issues of public health, is a selfless crusader, a throw-back to a time when public service was the highest calling. She is the first to say that she has learned much on the job, in particular about humanizing communications and the need to tell stories to buttress the traditional CDC reliance on science and facts.
I’m sure we will hear much more from this dedicated and passionate advocate for public health.
Posted by Edelman at January 13, 2009 4:16 PM |
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Comments
The CDC is one of the best "bang for the bucks" that we as taxpayers get. Thanks for sharing Dr. Gerberding's observations. I agree with Dr. Gerberding that winning the fight against smoking and obesity are sure fire ways to improve the overall health of our country, as both are nearly 100% behavioral change. With the web greatly expanding the number of media sources available, it will be interesting to see how PR will help our public health institutions achieve those and other objectives.
Posted by: Steve Shannon at January 13, 2009 9:22 PM