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Echo report published by Maria Shriver in "Sunday News".
“ As a professor at Massachusetts General
Hospital and Harvard Medical School, I never imagined I would be called to
become the 19th Director of the US Centers for Disease Control and Prevention
(CDC). And I certainly did not anticipate seeing myself serving in that role
during the largest pandemic of our lifetime,”
Former CDC Director, Rochelle Walensky: “Here’s What to Know About What’s Happening to Our U.S. Health
Agencies—and Why Doctors and Scientists Are Worried”
By Dr. Rochelle Walensky
It happens every week. An unexpected phone call or
email from a family member, colleague, friend, and even friends of friends
telling me some version of this: “My enter name of loved one has just
been diagnosed with enter name of terrible disease.” What follows is
a plea for help—an urgent request for a referral to the best specialist, an
appeal to find the leading scientist who might offer hope based on a newest
discovery or therapeutic.
Whether you’re the one making the call or the one
answering it, in that moment, your only wish is that medicine and science have
advanced far enough to save a life. With the current changes happening at our
nation’s premier health agencies, I fear we are taking steps in the wrong
direction, ultimately destabilizing US science and demoralizing its dedicated
talent pool.
I am an infectious disease clinician, drawn to this
field by what I witnessed during my training in the mid 1990s: A generation
dying of AIDS. Over time, my research turned to HIV-related policies on drug
costs, access to care, and the value of treatment. As a professor at
Massachusetts General Hospital and Harvard Medical School, I never imagined I
would be called to become the 19th Director of the US Centers for Disease
Control and Prevention (CDC). And I certainly did not anticipate seeing myself
serving in that role during the largest pandemic of our lifetime.
When I received my CDC business cards, the numbers
“24/7” appeared boldly on the back—a stark reminder of the CDC’s never-ending
mission to safeguard the health, safety, and security of all Americans and, by
extension, people around the world. Though I was deeply familiar with the CDC’s
infectious disease work, I quickly came to understand the agency’s vast
scope—from tracking rabies in imported dogs and the health of miners and
fisherfolk to the surveillance of emerging outbreaks in over 60 countries.
The paradox of public health is that when it works
as it should, it remains invisible. No headlines, no crises, just silent
prevention. Most of the time, that’s exactly what happens.
As the Director of the CDC from 2021 to 2023, I had
a front row seat to the US public health agencies. Now, from the sidelines, I
am witnessing the world’s premier US public health agencies in the news once
again. This time, the news is not predominantly about the next crisis they are
heroically tackling, but instead it is about their undoing. Like so many of my
peers who have devoted their entire careers to science and medicine, I am
distressed every time I see a headline about the indiscriminate undermining and
dismantling of our public health agencies. Doctors and scientists are profoundly
worried. Here are just a few reasons why.
Our health agencies study and recommend vaccines to
prevent infection and even eliminate diseases.
In my 25 years of clinical practice, I encountered
only one case of measles. The patient was exposed in an airport terminal two
hours after the “index patient”—the first identified case who had
measles—had departed. The two never encountered one another. That is how
contagious measles is.
We know this disease requires vaccination rates (or
immunity from prior infection) exceeding 95 percent to maintain robust and
reliable community protection—what’s referred to as “herd immunity.” The CDC is
in the vaccine business; the agency evaluates their benefits and risks,
determines the populations in whom to deploy them, and rolls out campaigns for
their implementation.
In recent years, vaccination rates among US
kindergartners have declined, with national coverage falling below 93 percent—a
fall from 95 percent pre-pandemic. Even this modest drop results in
consequences that are becoming alarmingly clear.
The epicenter of the current measles out breakin
Gaines Conty Texas, which has the lowest kindergarten vaccination rate in west
Texas, hovering around 82 percent. As I write this, there are 90 confirmed
cases, and some estimates suggest as many as 200 to 300 additional infections.
Notably, most of those affected were unvaccinated.
This is a big deal: Beyond the serious infectious complications that can result
from measles, such as pneumonia, brain inflammation and death, contracting the
disease can result in a weakened immune system and, for pregnant women, birth
defects in an unborn child. Prior to a widely available vaccine, measles
resulted in 400-500 deaths in the US annually, mostly children, which is more
than twice the current number of annual pediatric deaths due to influenza.
For decades, Americans had the privilege of debating
vaccine safety, not because they faced the horrors of these diseases, but
because vaccines had made them nearly disappear. Tragically, that tide is
turning, and we are becoming reacquainted with the morbidity and mortality
resulting from those very diseases vaccines have the capacity to prevent.
Public health servants dedicate their careers to
tracking deadly diseases. Firing them leaves all of us exposed.
Over the past year, one of the most alarming health
threats has been the evolution of H5N1—commonly known as “bird flu” or “highly
pathogenic avian influenza (HPAI).” This strain of the flu remains largely
unfamiliar to the human immune system, and many experts are saying H5N1 has
significant pandemic potential.
Since 2022, the virus has increasingly been detected
in wild birds and has since spread to commercial poultry, nearly 1,000 dairy
cattle herds across the country, and an expanding array of other animal and
human hosts across the country. The outbreak has had wide-ranging consequences,
from soaring egg prices to the first reported death of a patient in Louisiana,
who was exposed to H5N1 by a backyard flock.
Our federal health agencies work together to prevent
bird flu and control outbreaks when they occur. This is just one of many
examples of the work performed tirelessly by federal agency employees—work that
doesn’t end at the U.S. border.
Take Ebola, for example, a deadly virus that
belongs to a family of viral hemorrhagic fevers, alongside similarly lethal
diseases like Marburg, Rift Valley Fever, and Lassa Fever. Thanks to the
vigilance of trained local communities and the tireless work of many dedicated
employees at the CDC, the WHO, and other US and international partners, these
diseases are largely contained within Africa. Yet outbreaks continue to occur
and remain one flight away from spreading diseases across the globe. During my
tenure as CDC Director, we faced at least two Marburg outbreaks and one Ebola
outbreak, the latter claiming 77 lives.
As we all learned from HIV/AIDS in the ’90s, a
threat anywhere is a threat everywhere. In an
interconnected world, no country can tackle these dangers alone. Right now, an
Ebola outbreak in Uganda and Marburg outbreak in Tanzania are resolving, thanks
in part to the WHO, which allocated $5 million so that these contagious
diseases can be rapidly contained and do not reach us here in the US or
anywhere else around the world.
This is what partnership looks like. This is what
global solidarity demands.
Deep funding and staffing cuts threaten the next
generation of scientific leaders—and the big breakthroughs they’re working on.
The National Institutes of Health (NIH) boasts 174
Nobel Laureates among its investigators and grantees. Its work has transformed
medicine. Today, a person with HIV can expect a normal lifespan—an unthinkable
reality when I was in training. Pediatric leukemia, once a near-certain death
sentence, now has a cure rate exceeding 90 percent, which is a dramatic leap
from its cure rate of less than 10 percent just decades ago.
Throughout my entire research career, I was funded
by the NIH. Make no mistake, the grant process is brutally competitive. Funding
rates at some institutes hover below 10 percent, which means that on average, a
researcher must write 10 grants—each totaling 100 to 200 pages—just to be
awarded one. Even then, securing funding can take more than 1.5 years
from the submission of the initial application.
These odds are not for the faint of heart. They are
for the scientifically determined, the relentless seekers of discovery, the
ones who strive to have the answer when a loved one makes that desperate call
about a terrifying diagnosis.
A weakened NIH is not just a threat to the
pipeline—it is a threat to discovery itself. The scientific ecosystem is
delicate. To drive groundbreaking discoveries and transform them into tangible
individual and population benefits, the nation must sustain a robust NIH
alongside a flourishing, well-resourced network of US scientists and research
institutions. When those closest to us have serious questions about their
health, it is the results of this science that will enable those of us in the
medical field to provide answers.
As the foundations of global partnerships,
infrastructure, funding, and expertise falter at the federal level, scientists,
epidemiologists, and public health experts are sounding the alarm.
The enemies are not the people, they are the
pathogens. And the threat is not distant, it’s right here.
Rochelle Walensky, MD, MPH is the Bayer Fellow in
Health and Biotech at the American Academy in Berlin, and a physician
scientist. She served as the 19th Director of the Centers for Disease Control
and Prevention, Professor of Medicine at Harvard Medical School (2012-2020), an
Infectious Diseases (HIV) clinician. She is mother of three boys (her proudest
title), and wife.
Labels: bird flu, Maria Shriver, Rochelle Walensky, Sunday News
