United States Needs a Unified Approach to Public Health
Public health officials say the United States needs a plan and infrastructure to avoid the fragmented response to a new disease that marked its response to the COVID pandemic.
“We don’t have a systemic approach to medical product testing,” said Dr. Janet Woodcock, principal deputy commissioner for the U.S. Food and Drug Administration (FDA).
Dr. Mark McClellan, director of the Margolis Center at Duke University and a former FDA commissioner, agreed. He said public health officials should work with state and local offices to devise strategies and set up systems to streamline necessary research for the next virus.
“We didn’t have, and still don’t have, a unitized response,” McClellan said.
The pair participated in a forum hosted by the American Enterprise Institute (AEI) think tank on June 30. The forum moderator, Dr. Brian Miller of AEI, believes such discussions are the first step toward solving the problem. He said public and private health care entities need to communicate more.
“Public health infrastructure operated largely in a silo [during the pandemic],” Miller said.
Woodcock said the development of therapeutics and vaccines for COVID was hampered by a system that prevents centralization.
She said the United Kingdom, with its National Health Service, could gather and evaluate data and implement what was learned more quickly than the United States. She said the FDA was criticized for using research from Sweden and Israel, but they had the data available sooner than American researchers.
“We celebrate our federated approach, but sometimes we’re a victim of it,” Woodcock said.
“We are a country of countries in many ways,” he said.
McClellan said the problem is rooted in federal health care agencies with separate missions and funding. They don’t regularly communicate. So, they had to scramble to get the data when the pandemic came along. He said the problem was worse in the early days of the pandemic.
“This one didn’t quite come together,” he said.
According to McClellan, the Centers for Disease Control and Prevention (CDC), FDA, and the National Institutes for Health (NIH) have similar but distinct missions. With the CDC focused on communicable diseases, the FDA regulating medicines and food, and the NIH doing research, it’s understandable that they don’t always know what information the others have.
For example, he said the CDC’s mission to protect Americans from diseases that may present a health, safety, or security threat is very broad. So, it works with various research facilities, scientists, and others who can help with that mission.
He said the agency often oversees state and local agencies that receive federal funding. Gathering and organizing data from so many disparate sources is difficult.
“It’s understandable that it’s hard for them to put that all together. It’s a very broad mission,” McClellan said.
Agencies Need Answers
Woodcock added that there can be hundreds of studies at any time. She stressed the importance of a coordinated approach to ensure efficient and effective responses to future health crises.
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