Fw: JAMA: CDC Director Invites Participation in Disease Control and Prevention (fwd)

[Guest guest]

My brother has a friend that works at NIH and occasionaly sends information

regarding CJD and CDC to him. He forwarded this to me. Also he says the CDC

is now required to have active, attentive, responsive offices for public

liason as of this year.

This could be a person to write regarding Dr. Schonberger at CDC and his

mindless parroting of a figure they have no research to back up.

Dorothy

> Medical News & Perspectives - February 10, 1999

>

> CDC Director Invites Participation in Disease Control

and

> Prevention

>

> Marwick

>

> Washington-The time is ripe to begin an era of

> collaboration between

> those who seek to improve public health and those who

> provide health care

> to individual patients, said P. Koplan, MD, MPH,

> director of the

> Centers for Disease Control and Prevention (CDC), at a

> National Health

> Council briefing here last month. The result will

benefit

> not only physicians

> and public health practitioners, he said, but, more

> importantly, patients and

> the community in general.

>

> " Now is the time for the two groups

to

> pull

> together to enhance each other's

> performance, "

> said Koplan, who was named director

> (succeeding Satcher, MD, who is

> now

> Surgeon General of the United States)

in

> October

> 1998.

>

> The National Health Council is a nonprofit organization

to

> which more than

> 100 voluntary health agencies, professional

associations,

> industry groups,

> and other organizations with an interest in health and

> health care belong.

> Koplan told the representatives of these groups that,

> increasingly, as health

> care is delivered through managed care organizations,

> including the Health

> Care Financing Administration's Medicare and Medicaid

> programs,

> professional and voluntary organizations, and private

> groups, " We want to

> work with them as partners, pull together what we know

in

> public health,

> and develop some joint goals. "

>

> Explaining the sort of cooperation he has in mind,

Koplan

> suggested steps to

> control " the widespread and injudicious use of

antibiotics

> that has led to the

> development of antibiotic resistance in some very

important

> organisms. " He

> said, " This is hindering our ability to treat a wide

range

> of conditions.

> Controlling improper use is certainly in the interest of

> health care delivery,

> whether it's by physicians and nurses, managed care

> companies, or

> pharmaceutical companies.

>

> " We can save money by not using expensive drugs when

they

> are not

> needed; we can improve patient care, improve the quality

of

> care, and at the

> same time assist the whole community in decreasing the

> rates of developing

> resistance, " Koplan said. " This is just one example-of

> probably

> hundreds-whereby working together we can effect a better

> end for public

> health and health care delivery, but most important for

> patients and

> consumers and the community in general. "

>

> STINT IN INDUSTRY

>

> Koplan has spent his career at the CDC except for the

past

> 5 years, during

> which he was president of the Prudential Center for

Health

> Care Research,

> in Atlanta. There he succeeded Roper, MD, who

> earlier had left the

> CDC directorship for the Prudential post.

>

> Of his time at Prudential, which describes its work as

> " outcomes research to

> enhance the quality and effectiveness of Prudential

> HealthCare plans and

> managed health care nationwide, " Koplan said in an

> interview, " That

> experience did several things for me. It brought me

closer

> to clinical care and

> the issues involved in the management of long-term

chronic

> illness. It also

> showed me the incredible differences in [various parts

of]

> the American

> health care system and where we have to go, such as the

> need for outcome

> measures and quality assurance. It also showed me the

many

> remarkable

> changes that are taking place in the health care system,

> many of which are

> positive, such as the emphasis on prevention. The result

is

> that I am more

> knowledgeable now and can bring a slightly different

> perspective to public

> health. "

>

> In addition to heading the CDC, Koplan is administrator

of

> its affiliate, the

> Agency for Toxic Substances and Disease Registry, which

> administers the

> Superfund law that deals with the health effects of

> hazardous substances in

> the environment.

>

> A CRUCIAL RETURN

>

> Koplan returned to the CDC at a crucial time for all

public

> health agencies,

> especially those at the state and local levels. In 1988,

> the National Academy

> ofSciences documented deterioration in the US public

health

> infrastructure.

> Despite the passage of a decade, the situation doesn't

seem

> to have

> improved. " In the last few years there has been an

erosion

> of [financial]

> support at local and state levels as well as at the

federal

> level, " Koplan said.

>

> At the National Health Council meeting, Koplan said one

of

> his goals is to

> strengthen the public health system at all levels. State

> and county public

> health agencies " need much more in the way of resources

and

> assistance,

> and we hope to work with them toward that end. " Citing

the

> need for

> improved laboratories and data-handling systems, better

> communication,

> and better information, he said, " These are support

items

> that permit us to

> advance science and are vital for national public health

> action. "

>

> The CDC has increasingly assumed a broader role in

public

> health than its

> traditional tasks of acute disease tracking and pathogen

> identification and

> control. Adopting principles involved in disease

control,

> such as

> epidemiologic surveillance, the agency has, for more

than a

> decade, been

> applying them to injury control, smoking cessation

efforts,

> early detection of

> disease, assessment of risk factors, and the impact of

> chronic diseases.

>

> Koplan implemented some of these programs himself. He

was

> the first

> director of the National Center for Chronic Disease

> Prevention and Health

> Promotion, a position he held from 1989 to 1994. He

> established a national

> breast and cervical early cancer detection program in

1987

> and was among

> the first to focus attention on the global impact of the

> health hazards of

> tobacco.

>

> CURRENT GOALS

>

> While current agency priorities include strengthening

> science, he said, " We're

> not seeking just to advance knowledge or pursue

scientific

> truth. These are

> good things, but our goal at CDC is to take public

health

> action-and you

> can't take action unless you have some facts to back it

up.

> CDC is a service

> agency; we do research so that we can give better

service.

> I want to

> reinvigorate the concept at CDC that there's no higher

> calling than service

> and that we have the best portfolio for delivering it. "

>

> Another goal is promoting healthy living at every stage

of

> life. " The traditional

> focus of public health efforts has been on pregnant

women,

> infants, and

> children. That focus will be maintained, but

increasingly

> we know more and

> more about how to improve the quality of life for all

the

> population and for

> older Americans in particular. We know a lot about

health

> promotion and

> disease management approaches to chronic conditions such

as

> arthritis and

> diabetes, and we will be very active in promoting

> activities to improve the

> quality of life for our aging population, " he said.

" This

> is high on the CDC's

> agenda. "

>

> Finally, the CDC intends to expand its activities in

> support of global health.

> In its 50-odd-year history, Koplan said, the agency has

> always done a lot in

> international health; now he wants to increase that

effort

> through

> collaboration with the World Health Organization and

other

> entities. " There's

> not a health area where we can't learn something from

other

> countries, " he

> said. " Increasingly, we are finding that we aren't

> different from other

> countries. There's a real commonality of concern and

> interest. "

>

> Koplan is well aware of the challenges this agenda

poses.

> " We have a

> wide-ranging portfolio to grapple with the major health

> issues of the day,

> whether the problem is cardiovascular disease and its

risk

> factors, obesity

> and the sedentary lifestyle, or the ongoing battles

against

> tobacco,

> environmental hazards, toxins, and injuries. We are

> approaching these issues

> in a forceful manner, " he said.

>

> " But, " he warned, " we aren't going to do it alone. " In

> addition to working

> with other federal agencies, Koplan asked all the

members

> of the National

> Health Council to add his stated agenda to their

> priorities, saying, " We'll

> work with you. "

>

> (JAMA. 1999;281:501-502)

>