October 2009

Three Questions For . . . Thomas Frieden, CDC Director

As a young medical student, Dr. Thomas Frieden called for “an abiding national commitment to provide healthcare to all who need it.” Now, as the Centers for Disease Control and Prevention’s new director, Frieden, forty-eight, has his chance to make a countrywide impact. As New York City health commissioner, the fit father of two never wavered when implementing controversial programs such as a smoking ban and a trans fat ban. Though Frieden traveled the world combating tuberculosis for the CDC in the nineties, this is the first time he’s been based in Atlanta. —interview by Mary Jo DiLonardo

Who are some of the CDC’s unsung heroes? The laboratorians, the people who do the lab tests. Who confirmed H1N1? It was the lab. The laboratories are one of those real treasures of the CDC, the basis of what we do day in and day out. One of the things that has been quite striking to come back to is how wonderful the buildings are. When I left CDC, we were still in Quonset huts.

Speaking of H1N1, a recent White House report says between 30 to 50 percent of the U.S. population may become infected. What’s the latest on the vaccine? H1N1 is certainly the thing that is the most urgent and challenging, from the first day I’ve been there through today. Influenza is probably the least predictable of all infectious diseases and probably the one that can cause the most harm. We are expecting 45 million doses of vaccine will be available by mid-October and 195 million by the end of December. The vaccine is being provided without cost, but there may be an administration charge to receive the vaccine. The goal is to have vaccine easily accessible throughout communities. Venues for vaccination could include school-located clinics, provider offices, retail pharmacy chains, and public health clinics. It’s most likely going to be two doses for many people, and that means it’s going to be very challenging to get many people to take the vaccine.

Due in large part to your New York antismoking initiative, the city has 350,000 fewer smokers than seven years ago. Do you plan on stricter restrictions for the rest of the country? No one should have to breathe cancer-causing chemicals just to hold a job. Workers, whether they’re restaurant or bar workers or other people, really do have a right to come to work and not be exposed to chemicals that are going to increase their risk of cancer and heart disease and stroke. Smoke-free legislation doesn’t hurt business. That’s been shown over and over again. But it’s up to every jurisdiction and their political leadership to make the decision. And it’s not easy. In New York City it was very controversial to pass a smoke-free law, but by the first anniversary hardly anyone noticed.

Photograph by Kendrick Brinson