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Politics confound H1N1 handling, speaker says

Though the presidential transition at the Centers for Disease Control and Prevention provided some temporary freedom in decision-making, politics play a large role public health policy, especially at a time of high alert such as the H1N1 outbreak, a CDC former director said.

Richard Besser, CDC acting director during the presidential transition and the initial outbreak of swine flu from January to June 2009, gave a lecture titled ‘Pandemics, Public Health and Political Transition’ on Friday to a group of about 150 students, educators and parents at the Sargent College of Health and Rehabilitation Sciences as part of the 11th annual Dudley Allen Sargent Lecture Series.

While at the CDC, Besser said he had to address the swine flu crisis and decide what measures would best promote public health and least disrupt infrastructure.

‘I got the most first-hand perspective on a country’s response to a pandemic,’ he said.’

Besser said his situation was very different from standard operations of the CDC because of the presidential transition. During his time, the CDC did not have frequent vetting of their directives and could update the public with greater frequency.

‘We could, refreshingly, work at a purely technical and medical level without bureaucratic hangover or political considerations,’ he said.’

However, Besser said, this changed when swine flu became a major concern and things settled down at the White House.

‘We suddenly faced politics, and determining our plan of action was not only our responsibility, it became an issue of national policy,’ he said.’

Their discussions began to involve other government departments and organizations including the Departments of Education, Homeland Security, Commerce and Transportation, Besser said.

‘It took us a while to realize that making a decision about public health isn’t purely scientific,’ he said. ‘There is more to school closures and social policy than technical analysis of the disease.’

Besser said for any policy to be successful, the public must support the CDC’s action, which makes availability to the press and public very important.

‘You need to tell people what you know and when you know it,’ he said. ‘You can do the right thing, but if people don’t understand, you’ll fail and your policy won’t work.”

Besser, currently a senior health and medical editor at ABC, said he can see the journalistic perspective.

‘There is a tendency in the medical world to view the press with suspicion,’ he said. ‘But they can be a hugely powerful means of shaping both behavior and policy.’

Besser said a perspective of collaboration rather than confrontation is more useful for public health than conflict.

Sargent Dean Gloria Waters said she thinks the lecture went well.

‘Sargent asked Dr.. Besser to speak because it is an important topic to address in the health world and we always aim to have an engaging speaker who is at the front of health care issues,’ she said. ‘I was very happy with the lecture and Dr. Bresser’s address.’

School of Public Health graduate student Tina Kapadia said she thinks the lecture was very interesting.

‘I learned a lot and gained a lot of perspective on how government policy and interaction informs public health,’ she said.’ ‘

Howard Levine, a parent visiting his son in Sargent, agreed.

‘It was excellent,’ he said. ‘I got a lot of insight into government reaction and there is a lot more than meets the eye, especially between government agencies.’

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