Making the Case for Global Public Health: Your Role in Changing the Conversation

National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Lecture Series

Centers for Disease Control and Prevention August 14, 2014

Karen A. GoraleskiExecutive Director

American Society of Tropical Medicine and Hygiene

Recent History: Vector Borne Disease Program • Funded in Fiscal Year 2010 at $26.7 million, line

was zeroed out in President’s FY 2011 budget• CDC estimated impact of loss: approx 100 state

jobs and 24 CDC jobs

• Met with key appropriations staff • Developed ‘report language’ to restore funding• Organized sign-on-letter to appropriators, signed

by 15 public health organizations

ASTMH Actions

• RESULTS: Funding restored• Strong ‘report language’ in Senate appropriations

measure • Subsequent White House budget requests have

included funding for the program

Ongoing Advocacy for CDC – ASTMH Hill visits 2013-14 • Sen. Mikulski (D-MD)• Sen. Cardin (D-MD)• Sen. Franken (D-MN)• Sen. Schumer (D-NY)• Sen. Gillibrand (D-NY)• Sen. Coats (R-IN)• Sen. Donnelly (D-IN)• Sen. Brown (D-OH)• Sen. Portman (R-OH)• Sen. Toomey (R-PA)• Sen. Wicker (R-MS)• Sen. Cochran (R-MS)• Sen. Inhofe (R-OK)• Sen. Moran (R-KS)• Sen. Isakson (R-GA)• Sen. Blunt (R-MO)• Sen. Johanns (R-NE)• Sen. Durbin (D-IL)

• Rep. Ellison (D-MN-5)• Rep. Van Hollen (D-MD-8)• Rep. Maffei (D-NY-24)• Rep. Tonko (D-NY-20)• Rep. Walorski (R-IN-2)• Rep. Joyce (R-OH-14)• Res. Com. Pierluisi (R-PR)• Rep. Griffin (R-AR-2)• Rep. Fleischmann (R-TN-3)

•Rep. McMorris Rodgers (R-WA-5)•Rep. Granger (R-TX-12)•Rep. McCollum (D-MN-4)•Rep. Crenshaw (R-FL-4)•Rep. Roybal-Allard (D-CA-40)•Rep. Diaz-Balart (R-FL-25)•Rep. Dent (R-PA-15)•Rep. Ryan (D-OH-13)•Rep. Engel (D-NY-16)

Senate and House

OMB Conference Travel Directive Letters to OMB Interim Director and HHS Secretary Burwell:

“….[aspects of] OMB’s travel policy….has directly or indirectly led CDC… to significantly curtail the participation of our nation’s pre-eminent researchers in scientific meetings.”

ASTMH statement: “The government’s one-size-fits-all travel policy...is a detriment to our nation’s scientific enterprise and will result in slow scientific innovation and a negative economic impact on the United States and the world."

US Senate Committee on Homeland Security and Governmental Affairs

Chairman - Sen. Tom Carper (D - DE)Ranking member – Sen. Tom Coburn (R -OK)

OMB Conference Travel Directive

• Congress is gridlocked • But progress made on funding bills • Interest in getting something done before the mid-

term election • Still, likely another Continuing Resolution (CR): a

short-term CR through December• Little time left to appropriate FY15 funding bills: in-

district time now; back only 2 weeks in Sept; home until mid-term elections

Washington, DC

Washington, DC: What’s Next? • Government shutdown: real or distant

memory in voting booth? • Electorate’s “throw the bums out” mentality –

how pervasive? • Eric Cantor (R-7th-VA) primary loss to Tea Party

challenger, David Brat • House stays Republican• Senate a toss up but will be a squeaker

Two Worlds: DC and CDC/Public Health DC/Congress CDC/Public Health Election cycle view Long view

Annual funding; very sensitive to domestic issues

Research/programs require multi-year funding

Talking points: broad, easily understood

Complex story to tell

There is a point of TOO MUCH Never enough data

Speaks a unique language Speaks a unique language

High Priority: saving money, creating jobs

High Priority: protecting/saving lives

Two Worlds: DC and CDC/Public Health DC/Congress CDC/Public Health Tendency to see CDC as disparate parts rather than sum total

Agency funded by “line item”

Many supporters but often only for their ‘line item’

Agency is funded by “line item”

What is public health?? We are public health

You don’t tell me, I don’t know about it

The work will speak for itself

Live and breathe by constituents

Not accustomed to thinking as a constituent

“Every public health decision is made on a political decision.”

~William Foege, MD, MPH2012 Presidential Medal of Freedom

1977-1983, Director, CDC

What Resonates with Congress? Maintaining US leadership on the global stage

in innovation and technology Health Security

– CDC Global Health Security Agenda

• Makes trade point (commerce, business)

• Protecting the US • US is not solely

responsible • 3 simple points: prevent,

detect, respond

What Resonates with Congress?

Healthier workforce and communities are less susceptible to strife and conflict…. More likely to build their economies….Could lead to less dependence on US and….Perhaps one day, can be an economic partner.

Congress has Strong Economic Interest

CDC’s Strengths • Agency has high name recognition (brand

awareness)• Public has strong interest in health, wellness

stories• You have interesting stories to tell: “Disease

detective,” “virus hunter” engage audiences• Public health is about communities,

neighborhoods, families

• PHS uniform is impressive, commands respect and is highly visible

• Know your audience - how informed are they? What lenses are they looking through: economy, jobs, US leadership, health concerns…

• Start where they are• How will what you have to say relate to them?

Why should they care about what you are saying?

• Tell your story, not your data

Pointers

• Infectious • Quarantine/Isolation• Endemic, Pandemic,

Epidemic• Surveillance• Pathogen • Reservoir • Vector-borne

• Low-income or resource-poor settings

• Elimination/eradication/control

Language of science: poorly/not understood to just about everyone but you

Effective Info Sharing

“3 Things to Know”“What CDC is Doing”“Find the Latest Data” Links to social media

Trusted sourceProactiveRegularly receivedEasy to forward/adapt

Economic Argument

“The human and social value of safeguarding health is clear. It’s also important to business and to international prosperity.”

“Recognizing that health security equals a healthy economy, the Foundation connects CDC with private-sector businesses, philanthropies and individuals to do more, faster.”

• Flat Funding

• Sequester

• Federal Travel Cuts to Participate in Scientific Conferences

The Anti-Innovation Business Plan

America’s Health is Global Health

Former Department of Health and Human Service Secretaries Sebelius and Leavitt have both made the point:

“America’s health is global health.”

Additional observationsWhen you think you’ve gotten it tight and brief – cut another half out

Add to the webpages: Why “x” matters to America and Americans

Webpages are very top-down – hard to put a face to CDC other than the top levels

Be a regular participant in the DC professional society/associations/institutions/coalition circles

Reach out to ASTMH and others who can amplify your messages

Thank you.

Karen A GoraleskiExecutive Director, ASTMH

kgoraleski@astmh.org@goraleskik