ATLANTA -- When he takes the helm of the Centers for Disease
Control and Prevention on Monday, Dr. Thomas Frieden will bring a
solid record of success -- and controversy.
Some health experts believe Frieden will bring his aggressive
approach to promoting public health to the national scene, where
his stands on condom distribution, needle exchange programs for
drug users, and smoking and diet restrictions could clash with
political and industry groups.
Frieden has served as New York City's health commissioner for
the past seven years and he defends his strong stands on health
issues.
He spearheaded a campaign to increase taxes on cigarettes and
ban smoking in restaurants and bars. He supported needle exchange
programs and condom distribution to help prevent AIDS, producing
condoms with the city's NYC logo and the slogan "Get Some."
He enraged restaurant owners when he expanded the city's smoking
ban to include all workplaces, including restaurants and bars.
"The key for me is not being controversial," he said. "The
key for me is having an impact."
Some groups are already girding for battle.
"Are we going to have a national condom distribution program,
funded by the taxpayers?" said Sadie Fields, chairwoman of the
Georgia Christian Alliance.
Of Frieden, she said, "He seems to have a propensity to force
his political and personal agenda on the individual."
It remains unclear whether Frieden will start pushing these
issues. He speaks of his priorities more broadly, saying he wants
to help CDC better track health problems, work more with state and
local health agencies, and strengthen global health activities.
Still, his passion shows when he speaks of the health impacts of
smoking.
"Clearly this is a very high priority," Frieden said of what
he called the leading preventable cause of death in the U.S. "CDC
does great work in this area, and there's more that can be done."
He also stressed that most public health work is not
controversial. He pointed to his success with improving electronic
records and colon cancer screening in New York City.
Frieden takes control of one of the world's major health
agencies after the departure of Dr. Julie Gerberding in January.
She had been criticized by some who said she allowed politics to
trump science at the agency, a charge that her supporters denied.
Frieden emphasized that the agency's work will be driven by
science. Some decisions are made by politicians, but he said he
wants to make sure they have the best information available.
Ken Thorpe, a health policy professor at Emory University, said
he believes President Obama tapped Frieden due to his successes in
New York City. The president is looking for new ideas that lead to
healthier lives and lower health care costs, and Frieden's emphasis
on illness prevention is right on track, he said.
"If we're going to (lower health care costs), we need new
aggressive, innovative ideas -- and some might not be popular,"
Thorpe said.
Jeff Levi, executive director of the Trust for America's Health,
a public health watchdog group in Washington, said he hopes Frieden
brings his proactive philosophy to the national health care debate.
At the same time, Frieden's influence will be limited because
CDC is not a regulatory agency that can serve up new taxes and food
prohibitions. These have been the work of state and local
governments, Levi said.
But some groups worry that Frieden will blur the lines between
state and federal responsibilities, pushing an agenda that they see
as meddling with people's personal decisions about what they eat
and how they live.
Moreover, Frieden will have a bully pulpit from which to speak
and President Obama's ear, said J. Justin Wilson, a senior research
analyst for the Center for Consumer Freedom, a group with backing
from the restaurant industry.
"He's probably the most controversial public health figure in
the country," Wilson said.
Of course, Frieden starts off with a major issue that is already
generating some controversy -- the handling of the new strain of
swine flu. He will have to decide whether to widely distribute
vaccine for the virus, at a time when many Americans believe the
threat has been overblown.
"Those are decisions that will have to be made with the best
information at hand," Frieden said.
Craig Schneider writes for The Atlanta Journal-Constitution.
E-mail: cschneider@ajc.com.
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