CDC Principal Deputy Director Visits URMC, Discusses State of U.S. Public Health

Anne Schuchat, M.D., principal deputy director of the Centers for Disease Control and Prevention (CDC), visited the University of Rochester Medical Center on October 14 to deliver the 6^th Annual Bernard Guyer Lectureship in Public Health, an event sponsored and supported by the Center for Community Health. In her talk, Schuchat discussed the changing landscape of public health in the U.S., praising URMC for its role in advances of the past century and looking forward to the challenges of the next.   

Schuchat was introduced by the lectureship namesake, Bernard Guyer, M.D., (UR ’70), Zanvyl Professor of Children’s Health, Emeritus, at the Johns Hopkins Bloomberg School of Public Health. Guyer paid homage to the late Donald A. Henderson, M.D., (UR ’54), M.P.H., leader of the war on smallpox that resulted in the first and only eradication of a human disease in 1980. Henderson died on August 19, at age 87, after a long and productive career in public health.

Schuchat touted the control and prevention of infectious diseases, like smallpox, as some of the greatest achievements in public health over the past century. She also congratulated URMC’s important role in developing the first vaccine against Haemophilus influenzae b (Hib), the leading cause of bacterial meningitis in children under 5 years old.  She also noted the critical contributions of the URMC to the development of Human Papillomavirus and Pneumococcal Conjugate vaccines.

The dramatic decline in infectious disease deaths over the past 100 years, though often attributed solely to the advent of antibiotics and vaccines, actually started with public health efforts toward pest control and improved sanitation, hygiene, and education. Public health initiatives continue to be instrumental for implementation of programs to properly utilize antibiotics, vaccines, and other life-saving drugs for maximum effect.

In fact, Schuchat believes public health, as a practice, is where innovation meets implementation. “We need to make sure that we don’t just create breakthroughs, but actually use them,” she said. “We can’t leave tools on the shelf.”

Schuchat highlighted some recent public health victories that have done just that. The CDC’s development and issuance of guidelines on prenatal screenings, which she spearheaded, is credited with the steep drop in early onset group B streptococcus infections in the 1990’s.  The Vaccines for Children Program, in which UR pediatricians played a pivotal role, was another huge success. The program made vaccines available to millions of uninsured children in the U.S., preventing an estimated 732,000 deaths in its first nine years, according to the CDC.

Some of the greatest achievements of the 21^st century were similarly born out of implementation of health policies. Seatbelt and DWI laws have been instrumental in preventing motor vehicle crash deaths, policies to decrease barriers to effective contraception contributed to a nearly 50% drop in teen births over a seven year period, and anti-tobacco ads featuring former smokers were deemed highly effective at reducing adult smoking in the U.S.

But for all of its successes, the U.S. is still grappling with some huge public health threats, with drug addiction and overdose topping the list. In order to stop this national crisis, Schuchat believes we should take a page from the smoking prevention and cessation playbook to incite a culture change. Other great challenges we will face in the near future include infectious disease epidemics, like Ebola and Zika virus, and antimicrobial resistant superbugs.

“Tasks of this century will be all about protecting the gains of the last,” said Schuchat.

To meet these challenges, Schuchat recommends strengthening the link between public health and healthcare, a sharp focus on implementation of the tools that are currently available, and taking public health from “denominators to democracy” – engaging those who are directly affected by or at risk of an illness in our research, policy and implementation efforts.  Her parting words were to take public health from something that is invisible, as many of these programs fly under the public’s radar, to something unforgettable. 

Michael Hazard | 10/20/2016