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Tom Frieden
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PS: You are President and CEO of Resolve to Save Lives, which recently produced a report on “epidemics that didn’t happen, or whose impact was lessened, because of careful planning and swift strategic action.” At the Back to Health event, you will participate in a panel on preventing the next pandemic. What do the report’s case studies tell us about effective or innovative approaches to pandemic prevention?

Tom Frieden: Epidemics don’t have to spread uncontrollably and cause devastating loss of life. Our report highlights the great work of public-health professionals around the world and shows that if we work together, and follow the science, we can make the world a much safer and healthier place.

The eight case studies in the report show that devastating human and economic losses can be avoided with a few simple ingredients: modest but sustained investment; strengthened public-health systems; better coordination among – and communication by – determined leaders; and structures that detect, respond to, and contain infectious-disease outbreaks before they grow into epidemics.

Infectious diseases and other health threats will not stop with COVID-19. That’s why we need to ensure that our public-health systems are prepared to handle the next pandemic threat. The last year has highlighted the critical importance of global, regional, and local-level coordination aimed at building the resilience needed to weather – and mitigate – future health emergencies. Acting now to implement preparedness and response systems will save millions of lives and trillions of dollars.

PS: You recently listed “six urgent steps the world must take to become far more pandemic-proof.” Let’s consider primary care, which you point out is vital to pandemic prevention. If a country wants to strengthen its primary care system, where should it start?

TF: Countries should seek not only to strengthen primary health care, but to make it the center of their health-care system, thereby establishing preservation of health and prevention of disability as the system’s organizing principle. This would revolutionize health care, which today tends to be disorganized, ineffective, and ultimately wasteful. By improving population and community resilience, countries would reduce the risk and harm of future health crises.

To this end, countries must build political consensus on key priorities, including ensuring long-term funding, making the most of community health workers and full health-care teams, and integrating public health (and public-health teams) into the health-care system.

In the United States, Congress can establish sustainable mechanisms that ensure we invest in our core public-health infrastructure and health-security programs to break the deadly cycle of panic and neglect. This is best achieved through a permanent exemption from budget caps for our health defense – that is, public-health functions that are critical to prevent, detect, and respond to infectious diseases. The creation of a Health Defense Operations budget designation would exempt critical health funding from spending caps, enabling our public-health agencies to protect us as effectively as possible.