May 9, 2010: I am scheduled to speak to several Rotary Club groups about Inside the Outbreaks. Rotary International clubs have given over $850 million to support global polio eradication, which is tantalizingly close to succeeding. I covered a great deal about polio in my book, from the Salk vaccine to the present eradication effort.
But that’s not why I’m writing this. It’s to lead into a frustrating phone conversation I had recently. One Rotarian in charge of programming told me, “Our members wouldn’t be interested in hearing from you because they are primarily interested in politics.” This flabbergasted me. I blurted out, “But public health is politics!” I couldn’t convince him, but it is true. The more I researched the history of the Epidemic Intelligence Service, the more I found that politics influenced what impact EIS officers could have. The CDC (of which the EIS is a subset) has no regulatory power. It can only make recommendations. Thus, for instance, when EIS officer Karen Starko first documented that aspirin caused most cases of Reye syndrome – a horrible affliction that killed thousands of otherwise healthy children – the FDA quickly moved towards insisting on a warning label for all aspirin-containing medicine for children. The powerful aspirin industry lobby interceded and managed to block the label, insisting on more delaying studies for another five years. In the meantime, nearly 300 more children died of Reye syndrome. Once aspirin was finally removed from children’s medications, Reye syndrome became an extremely rare disease in the United States.
It is clear that legislation (i.e., politics) is a potent public health tool. Putting high taxes on cigarettes and keeping ads for them off television are good illustrations. Yet our legislators are generally not terribly well-informed about public health issues. So here is my sermon for this Sunday – I would like some public health veterans – perhaps EIS alums – to run for public office, nationally and locally. One of the few criticisms I have of these folks (whom I admire a good deal on the whole) is that they aren’t vociferous enough about what they discover and what urgent issues we face. The CDC led the way in documenting foodborne E. coli O157:H7, for instance, but it took citizens’ groups to push successfully for new legislation for beef inspection, which the USDA has implemented.
I have heard inspirational public health speakers such as Bill Foege and Nils Daulaire, and I found myself thinking, I would love to vote them into office, any office. I want more people to hear them. I want them to have more clout. Foege is too old now, I’m afraid, but Daulaire, who for years headed the Global Health Council and has now been tapped by President Obama as his new Director of the Office of Global Health Affairs, would be a good candidate. Instead of waiting to be appointed, how about public health experts running for president next go-round?