New CDC chief controversial

By Craig Schneider

The Atlanta Journal-Constitution

When he takes the helm of the Centers for Disease Control and Prevention on Monday, Dr. Thomas Frieden will bring a solid record of success —- and controversy.

Some health experts believe Frieden will bring his aggressive approach to promoting public health to the national scene, where his stands on condom distribution, needle exchange programs for drug users, and smoking and diet restrictions could clash with political and industry groups.

Frieden has served as New York City's health commissioner for the past seven years and he defends his strong stands on health issues.

He spearheaded a campaign to increase taxes on cigarettes and ban smoking in restaurants and bars. He supported needle exchange programs and condom distribution to help prevent AIDS, producing condoms with the city's NYC logo and the slogan "Get Some."

He enraged restaurant owners when he expanded the city's smoking ban to include all workplaces, including restaurants and bars.

"The key for me is not being controversial," he said. "The key for me is having an impact."

Some groups are already girding for battle.

"Are we going to have a national condom distribution program, funded by the taxpayers?" said Sadie Fields, chairwoman of the Georgia Christian Alliance.

Of Frieden, she said, "He seems to have a propensity to force his political and personal agenda on the individual."

It remains unclear whether Frieden will start pushing these issues. He speaks of his priorities more broadly, saying he wants to help CDC better track health problems, work more with state and local health agencies, and strengthen global health activities.

Still, his passion shows when he speaks of the health impacts of smoking.

"Clearly this is a very high priority," Frieden said of what he called the leading preventable cause of death in the U.S. "CDC does great work in this area, and there's more that can be done."

He also stressed that most public health work is not controversial. He pointed to his success with improving electronic records and colon cancer screening in New York City.

Frieden takes control of one of the world's major health agencies after the departure of Dr. Julie Gerberding in January. She had been criticized by some who said she allowed politics to trump science at the agency, a charge that her supporters denied.

Frieden emphasized that the agency's work will be driven by science. Some decisions are made by politicians, but he said he wants to make sure they have the best information available.

Ken Thorpe, a health policy professor at Emory University, said he believes President Obama tapped Frieden due to his successes in New York City. The president is looking for new ideas that lead to healthier lives and lower health care costs, and Frieden's emphasis on illness prevention is right on track, he said.

"If we're going to (lower health care costs), we need new aggressive, innovative ideas —- and some might not be popular," Thorpe said.

Jeff Levi, executive director of the Trust for America's Health, a public health watchdog group in Washington, said he hopes Frieden brings his proactive philosophy to the national health care debate.

At the same time, Frieden's influence will be limited because CDC is not a regulatory agency that can serve up new taxes and food prohibitions. These have been the work of state and local governments, Levi said. But some groups worry that Frieden will blur the lines between state and federal responsibilities, pushing an agenda that they see as meddling with people's personal decisions about what they eat and how they live.

Moreover, Frieden will have a bully pulpit from which to speak and President Obama's ear, said J. Justin Wilson, a senior research analyst for the Center for Consumer Freedom, a group with backing from the restaurant industry.

"He's probably the most controversial public health figure in the country," Wilson said.

Of course, Frieden starts off with a major issue that is already generating some controversy —- the handling of the new strain of swine flu. He will have to decide whether to widely distribute vaccine for the virus, at a time when many Americans believe the threat has been overblown.

"Those are decisions that will have to be made with the best information at hand," Frieden said.