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Alliance Discussion with Dr. Howard Zucker: Ensuring a Healthier Future through CDC’s Global Initiatives

Complex and longstanding challenges are keeping our world out of balance, making us all more vulnerable to threats that could impact the future wellbeing of millions across the globe. We have a window of time as we recover from the impacts of COVID to innovate and improve global health. Dr. Howard Zucker, Deputy Director for Global Health at the Centers for Disease Control and Prevention (CDC) joined us to discuss the CDC’s work abroad and how it is instrumental in protecting the health of the United States and the international community. Here are some of his thoughts on:

Earth’s “underlying conditions” that are challenging global public health efforts:

“If we were to do a clinical exam and put our metaphorical stethoscope up to the globe, we discover that it’s out of balance. It has some underlying conditions that are making it harder for public health to save lives. Big issues that make it more difficult for us to do our job by demanding our already scarce resources, exacerbating existing health problems, and creating entirely new ones. In medicine, we know you can’t treat a condition effectively until you diagnose it. So, what are the conditions our global patient is suffering from?”

“The first thing our examination reveals is that the world has a chronic fever. In 2023, the world saw the highest global temperature in over 150 years of record keeping. As temperatures rise, so can premature deaths from ozone, particle pollution, and heat. We see more flooding, and with that increases in risks of waterborne diseases. Milder winters, warmer summers, and fewer days of frost make it easier for diseases to expand into new geographic areas and infect more people. Changes in temperature, rainfall, and humidity alter the environmental suitability for the transmission of many mosquito-borne diseases such as dengue, malaria, vibriosis, and West Nile virus. The United States reported locally acquired malaria cases for the first time in 20 years. Right now, CDC is closely watching the spread of Anopheles stephensi mosquito, which thrives in urban areas and could put 126 million more people in Africa at risk [of malaria], but also watching the spread of Dengue. […] In the face of events like these, public health must work harder to reduce suffering and save lives. To win this fight, we need more tools in our toolbox. That’s where research comes in.”

How CDC is addressing the growing threat of antimicrobial resistance:

“Today, we’re losing this miraculous ability to treat and prevent even the most common infections. In 2019, antimicrobial resistance bacteria were estimated to cause more deaths than HIV or malaria worldwide. We know now antibiotic resistant germs can share their resistance genes with other germs and can make them untreatable. That’s why antimicrobial resistance, AMR or just AR, is something CDC and the international community are highly focused on. […] Detecting dangerous and deadly AR threats is a top priority for CDC. Last year marked the 10-year anniversary of CDC putting out the very first AR Threat Report, but we’ve also known that no single organization can solve the problem of AR on their own, so we work closely with others in this space. The CDC collaborates with more than 100 public and private institutions across the globe to innovate against AR. In December 2021, we established the Global AR Lab and Response Network spanning nearly 50 countries and working with more than 20 organizations worldwide. Globally, networked surveillance gives us early warning and helps prepare our labs here in the United States for impending threats. And with whole genome sequencing, we’ve been able to take advantage of some of the global capacity built during the COVID pandemic, to identify drug resistant patterns, mutations, and disease transmission.”

CDC’s global partnerships:

“Through [CDC’s] decades long partnership with Kenya Medical Research Institute (KEMRI), we worked on the development and adoption of the first malaria vaccine less than two years ago. The data was so strong that it led to the early release of recommendations to implement the new RTS,S vaccine. 40+ years of partnership between CDC and KEMRI is driving even more waves of innovation, including studying the effectiveness of monoclonal antibody products, like the NIH product L9LS, as a tool to help children in high transmission settings.”

“One of the most significant things CDC does is support 60+ country offices. We’re working with Ministries of Health to build, to modernize, to strengthen health programs that save lives and create a safer world. So, when outbreaks happen, we have boots on the ground to know what’s going on quickly. In 2024, we have plans to open two new regional offices, one in Japan and one in Panama, to grow even closer relationships in more parts of the world. We continue to build health security capacity in more of our partner countries, improving performance in surveillance, in laboratory, on disease reporting, investigations, and response, and strengthening the workforce. We’re working on initiatives this year to improve early detection and rapid response to emerging threats.”

The role of research and innovation in patient care:

“I’m personally excited about the road ahead for research and innovation work that can be done between CDC, the private sector, and academic research communities. With all of you here today, we understand the potential of technology to increase the role patients play in their own clinical care. Blood pressure monitors at home or at the local pharmacy, a watch on your wrist that monitors your vital signs all day, insulin pumps, home pregnancy tests, oximeters, and portable defibrillators that are everywhere. All these capabilities we never dreamed of even 50 years ago. Now, technology is also increasing the role patients play in public health response. For example, you take a COVID test at home, use your mobile phone to report a positive test and you alert others to your exposure, or potential exposures that they may have had. We can think about how to drive this potential even further in the coming year. How to make health more accessible, more available, more affordable, and equitable across the world.”

CDC initiatives to prepare for future health threats:

“I think it’s all about the power of investing in preparedness, which is so important. CDC has looked at over 100 disease threats that have happened over a long period of time. And some of the things we do, is we work in countries to help train those in their country to become disease detectives. We have a field epidemiology training program, over 20,000 people have been trained over the last 40 years in about 80 countries, and they are our eyes and ears.”

Recommendations for scientists and physicians who want to engage with the public to tackle these issues:

“It’s really important on the physician level to advocate by first advocating with your patients; by making sure that they do the right things when it comes to public health, when it comes to preventing disease spread, and hand washing, and vaccines. Then on a broader level with their patients, and with the public in general, to make sure that they recognize that there is a lot of misinformation, disinformation out there, and to push back and fight back on that. To say, “this is the science, this is the information, this is what we know today”, and to carry that message forward. Also, to work with organizations who have made this their passion. And then too, getting involved and engaged, particularly with those who are earlier on in their career, and work with them. I’m thrilled that the next generation and the generation after are all going to be committed to doing this, to help us, because that’s the only way we’re going to solve some of these problems that I spoke about today.”

Watch the full discussion here.