Key Takeaways From Our #FriendsHealthChat with Dr. Tom Frieden

Dr. Tom Frieden, president and CEO of Resolve to Save Lives and former director of the Centers for Disease Control and Prevention (CDC), spoke with Friends President and CEO Chris Collins on April 28 about health security and how the United States and the world should take action to prepare for the next pandemic.

When discussing the COVID-19 pandemic, Dr. Frieden stated that “there has never been as teachable a moment as the present. With more than $10 trillion of costs, with more than 3 million deaths… we have not just an opportunity, but a responsibility to make the world a safer place.”

During the discussion about his article published in BMJ Global Health titled “The World Must Prepare Now For the Next Pandemic,” Dr. Frieden explained the major reforms and investments the U.S. and partners should make to increase preparedness. While funding is needed and necessary for global preparedness, he said funding alone will not be enough for success. He particularly stressed the importance of having strong management. “Every aspect of public health requires good management… If you take HIV, TB and malaria, management is essential. Whether that’s managing bed-net distribution programs or ensuring cohort analysis so you’re tracking the outcome of patients,” he said.

Dr. Frieden also discussed the current role of global health programs in pandemic preparedness and health security and what a strengthened preparedness architecture would look like. He stated that a strengthened World Health Organization (WHO) should be at the center of global health programs, while the Global Fund can play a bigger role in strengthening global preparedness. “The Global Fund is effective at working in-country, it’s effective at moving resources accountably. This has to be done carefully because the stakeholders are different at the national level for preparedness than they are for HIV, TB and malaria, but the Global Fund is, in my view, the most likely major contributor to rapidly improving preparedness globally,” he said.

Dr. Frieden also emphasized the importance of primary care in the health security agenda, asserting that primary care is often ignored and progress should be made towards building stronger health systems. “Primary care systems are crucial to the care of HIV, to preventing death from malaria, to the treatment of TB and in our own work to the treatment of hypertension, and yet they are really quite weak around the world.”

Reflecting on his work in tackling the Ebola epidemic starting in 2014, Dr. Frieden discussed the lessons he learned to establish an effective response and be prepared for future pandemics. He stated that every community has its strengths and weaknesses, and recognizing those is important, as well as having an organized response with strong communication.

When asked about the state of the current TB pandemic, Dr. Frieden stated that persistence is the key. With regard to the impacts of COVID-19 on TB, he stated that “right now, we are in a terrible situation. TB control has been set back for years… Many patients weren’t diagnosed, many patients didn’t continue treatment, there has been a huge spread of TB.” He also stressed the need to scale up TB services to address this setback due to the pandemic.

As the conversation concluded, Dr. Frieden stressed the importance of communities. He mentioned that both community health workers and community organizations play a central role in health care systems, and that community health workers should be paid, trained and respected for the work they do. Currently, he said, they are not supported enough and the world needs a financing system that buttresses and expands their crucial role.