Dr. Thomas Frieden, New York City's outspoken health chief, takes control of the Atlanta-based Centers for Disease Control and Prevention on Monday.
He moves from running a big-city health department to a world-size agency with some 9,000 employees and a mission that includes tracking the nation's health, addressing health crises abroad, and protecting the U.S. in the event of a biological terror attack.
As head of the New York City Department of Health and Mental Hygiene, he helped lead initiatives to reduce smoking, eliminate artificial trans fat from restaurant food and require posting of calorie information in chain restaurants.
He takes over the CDC at a time when it is one of the major health agencies on the globe. But over the past eight years, the agency has been accused of sacrificing science in favor of politics, a charge denied by the former regime. He answered some questions about his plans.
Q: What are your priorities going into the job of CDC director?
A: The first thing I want to do is to get to know and learn from the wonderful staff over at CDC. I want to listen.
I want to strengthen our science base — how well we track health problems and how well we monitor how well we're doing. I also want to improve our ability to help state and local health departments. And I want to strengthen our abilities and our activities in global health, because a safer world is a healthier world.
Q: The prior CDC leadership was accused of placing politics above science. What do you believe the roles of politics and science should be at CDC?
A: It is very clear from President Obama and [U.S. Health] Secretary [Kathleen] Sebelius that there is a deep and abiding commitment to science and to basing decisions on science. I think the role of CDC is to get the information we need to make informed decisions. Some of those decisions are political decisions, and it's CDC's role to provide the information so that the political decisions are made with the best information available.
Q: Do you believe the prior administration placed politics above science?
A: I can't comment on what's happened in the past. I'm going to be focusing on the future. [I'm] going to focus on getting information and making that information available openly and transparently.
Q: CDC has been accused of overblowing the recent outbreak of swine flu. What are your plans for handling it?
A: There's no question that a new strain of influenza spreading rapidly throughout the world is a major problem and requires a major response. So far, it doesn't seem to be any more severe than seasonal flu, but seasonal flu kills 36,000 Americans a year.
We'll have to track what happens over the next couple of months, especially in those areas that have flu circulating, such as the Southern Hemisphere, and make some tough decisions about vaccination in the fall.
Q: Do you want to see a vaccine distributed widely in the United States?
A: It's clearly important that we move forward with the steps toward producing a vaccine. [At the same time] it's very important to reassess our actions regularly as we make decisions — so how much vaccine to make, whom to give it to, those are decisions that will have to be made with the best information we have at hand.
Q: Could you talk a little about CDC providing more to state and local health agencies?
A: It's a variety of things. It's technical support, it's practical guidance, it's money if there's money. Sometimes it's sending staff to work with partner organizations.
Q: Some of your views are controversial, such as your support of condom distribution and needle exchange programs. Are you looking to implement these issues on a national level?
A: I'll be looking at all of the issues, and seeing what makes sense and where. Different communities are different and what makes sense in different communities is different. It's clear to me that syringe exchange has played a important role in reducing the HIV epidemic in New York City.
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