CDC director Thomas Frieden has announced his resignation from his position at the Centers for Disease Control and Prevention. The federal agency’s main goal is to protect public health and safety through the control and prevention of disease, injury, and disability across the world. And our favorite anti-science president-elect, Donald Trump, will appoint his successor.
The agency focuses its attention on infectious disease control partially through advocacy for vaccines. The staff of 15,000 scientists, researchers, physicians, and US Public Health Services commissioned officers, are dedicated to investigating infectious diseases, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention, and public health educational activities – all are designed to help improve the health of Americans and people across the world.
CDC officials are often the first responders to ground zero of dangerous infections. They are generally the first scientists who determine the proper course of treatment for novel diseases, while monitoring its spread across a geographic area. They are warriors in the fight against diseases across the world, including Zika virus and many others.
A significant part of the CDC’s mission involves attacking public health problems globally. In today’s interconnected world, a disease that shows it’s ugly head in an isolated village in the Amazon can be transported to a major city in another country in less than 36 hours. This take money. And this takes manpower.
Let’s take a look at the career of CDC director Thomas Frieden, and the potential consequences of a Donald Trump appointee to the position.
CDC director Thomas Frieden
Dr. Frieden has the credentials of someone who should be leading the CDC. He is a physician who did a sub-fellowship (specialized medical beyond a residency) in infectious diseases. He went on to assist the government of India develop a network to treat tuberculosis. He was also Commissioner of Health for New York City from 2002-2009, after which he was appointed to be CDC director by Barack Obama.
Most recently, he directed the agency’s efforts to combat the Zika virus. This is how fast these novel diseases move – a year ago, the mosquito-borne virus was first observed to be a threat to pregnant women and the fetus. And because the disease had been identified in Brazil, the location for the 2016 Olympics, the CDC issued over 60 travel alerts with guidance for individuals, including athletes, traveling to the event. And as I mentioned above, CDC researchers and scientists deployed to ground zero for the disease, going to numerous locations. From that, they tested more than 147,000 lab specimens, began 25 major studies, and issued more than 230 scientific publications.
A year ago, the mosquito-borne Zika virus was only beginning to reveal itself as a threat to pregnant women and their unborn babies.
Since then, U.S. officials have issued 60 travel alerts along with guidance for athletes and tourists traveling to the Olympics in Rio. They have also deployed more than 1,000 experts to Puerto Rico and elsewhere, tested more than 147,000 lab specimens, initiated 25 major studies and issued more than 100 scientific publications.
But there’s been more under Dr. Frieden’s management. He dealt with the H1N1 flu pandemic, Ebola, MERS (middle-east respiratory syndrome), fungal meningitis and drug resistant bacterial infections. These diseases require a public health army to stop them in their tracks. These diseases aren’t something to be ignored because state governments do it better (in fact all rely upon the CDC) or because they aren’t dangerous. They are, and as far as I can tell, being white and privileged will not save you from the dangers.
One thing that should make you proud of a Federal official like Dr. Frieden is that he battled congress, nearly single-handedly, to extract an additional US$1.1 billion to research ways to stop Zika virus transmissions plus develop treatments. The disease was found in America, yet Republicans refused to give money for the effort (my cynical guess is that Republicans assume that the disease only hurts poor and black people, so they don’t care).
The CDC director serves at the pleasure of the President and has no fixed term. Technically, CDC director Thomas Frieden could have remained in the job, protecting the agency from the nastier effects of Trump anti-science beliefs, like his uncomplicated commitment to the anti-vaccine cause. But, Frieden’s resignation is not surprising, as incoming administrations usually do not retain the heads of federal agencies, most of whom are political appointees.
Donald Trump’s tiny hands now touch the CDC
With Dr. Frieden’s resignation, it’s now up to Trump and his minions to decide who will replace him. Generally, CDC directors have not been overtly political, and have significant science based public health background. Julie Gerberding, was Dr. Frieden’s predecessor in the position. Appointed by Republican President, George W Bush, Dr. Gerberding also had extensive research and clinical experience in infectious diseases and public health. For most of us who follow these things, we were neutral to positive about Dr. Gerberding. Of course, she was actually attacked in the so-called CDC whistleblower nonsense, as she supported the real science that vaccines do not cause autism.
My point is that the CDC has had, mostly, outstanding scientists running the show. Why? Because the diseases that attack Americans are apolitical. They don’t care whether you voted for Trump or Clinton. They don’t care if you’re in a blue state or red. They kill and harm at random. Vaccines save the lives of children of Democrats or Republicans. So politics ought to end at the parking lot of the CDC offices in Atlanta.
Unfortunately, it is simply not easy to maintain any kind of objectivity with regards to Trump’s “anti-science” appointments to various positions. He’s chosen a climate change denier to be in charge of the EPA. He has evolution deniers throughout his administration. He chose a member of a vaccine denying medical association to run Health and Human Services. Maybe Trump will appoint a flat-earther and Moon landing conspiracy theorists to run NASA.
First the good news (and this is pushing it). Trump is insisting on a Federal hiring freeze, though he specifically excluded the CDC. Hey, we’re at the point in watching Trump’s incredibly amateur management of his transition to power, we take whatever good news shows itself.
What concerns me and others is that Trump has specifically accused vaccines of being the cause of autism, which is scientifically ignorant and wrong. What if the “letter” to Trump, which demands that the head of public health officials acknowledge vaccines cause autism? Or what if Trump’s meetings with the anti-vaccine Mr. Andrew Wakefield means that Trump could appoint the cunning fraud Wakefield to the CDC? The chances of small, but don’t trust me, I thought the chances were tiny that Trump would win. Maybe Trump has another minion who’s got the proper anti-science credibility to run the CDC.
The CDC is more than just vaccines, although if their full-throated support of vaccination is part of their reasons for fighting the good fight against infectious diseases. They also identify new diseases and immediately try to determine if there are preventative measures. They watch for novel diseases arising in the USA and internationally. The xenophobic nature of Trump may make him reluctant to fight diseases outside of the USA, which means we are exposed to those same diseases, since we won’t have the scientific knowledge to fight them.
The CDC also monitors many other non-infectious diseases, like diabetes or heart disease, and often establishes the strategies to deal with the diseases effectively. Will Trump appoint a pseudoscience pushing ignoramus who will demand references to quack medicine on the CDC website? Since the anti-vaccine movement overlaps with other junk science like anti-GMOs and nutraceuticals, the CDC could be wasting their time on this ridiculousness.
I still want to hope that Trump will give us another person in line with Dr. Frieden as CDC director. But I’m not holding my breath.