Dr. Tom Frieden is tired of the lack of progress in reducing the global burden of cardiovascular disease and of infectious disease outbreaks. So Frieden, who resigned as director of the Centers for Disease Control and Prevention after eight years at the end of the Obama administration, says he wants to do something about it.
With significant contributions from some top-drawer funders, Frieden is launching a new initiative that he hopes will partner with existing players in the global health sphere — the World Health Organization, the CDC, the World Bank, and others — to persuade more countries to ban trans fats and lower the salt content in foods and shore up defenses against disease outbreaks.
Frieden, who is 56, bristles with energy. Retirement was not likely among the options on the table when he plotted his post-CDC career.
He spoke recently about his new venture with STAT. The following has been edited for length and clarity.
Tell us what you’re doing. You’re setting up a new NGO?
We’re launching a new initiative called Resolve to Save Lives that will prevent heart attacks, strokes, and epidemics with the goal of saving 100 million lives and making the world safer from epidemics. This will be housed at Vital Strategies, a terrific international organization that’s currently working in 60 countries and is based in New York City.
It’s funded at $225 million over five years by three very generous foundations: Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill and Melinda Gates Foundation.
That’s a good starting point.
Yes. I want to answer a question you haven’t asked yet.
OK, what is it?
You can insert question here. With the vantage point I have from the past eight years at CDC and the past 20 years working in global health, I identified specific areas where the world is at a tipping point. And with strategic investments we can make an enormous difference saving lives. And that’s how we designed this.
Both of the areas you’ve identified, heart disease and stroke, and then disease epidemics are important but they aren’t necessarily often married in the same program. Why do they make a good fit here?
The commonality between them is that they’re both at tipping points. In the next five years, it will become clear whether the world has continued to make slow or no progress in each of these areas, or if this announcement, along with our partners, represents an inflection point where we can see more rapid progress. And I’m hopeful that we will be able to show rapid progress.
What makes you think that this is a tipping point for these two areas?
The world has identified a target of reducing deaths from cardiovascular disease and has identified “best buys,” which need to be implemented in order to reduce cardiovascular disease. And while there have been lots of calls to action, there has been limited action actually making progress.
And that’s our kind of unique catalytic potential. With the generous resources that we have available, we’ll work with our partner organizations to rapidly implement programs that will address these problems.
This is not about inventing the things to be done. This is about taking great ideas that have been established and making them become great realities.
How do you do that on a global scale? Some of the problems will be common across a region or a couple of regions. But some of the hurdles or the logjams might be specific to a country or two. How do you effect change globally?
In cardiovascular we’ve identified three key interventions. The first is the global elimination of artificial trans fats, which kill 540,000 people a year and have got no reason to be in our food supply. The global reduction of sodium, with a goal of a 30 percent global reduction. And the global increase of hypertension treatment. Currently we’re only at 14 percent hypertension control globally, despite the fact that this is the world’s leading single cause of death — 10 million deaths a year — and that medications are cheap, simple, but not used.
In the preventing epidemics space, we will focus on the “core four” of surveillance systems, laboratories, trained epidemiologists, and rapid response teams. And then we can work strategically to identify the countries or in some large countries parts of countries where rapid progress is possible, and the partners who can accelerate that rapid progress.
Is no one else doing this? Does it take a new entity or a new program to get this work done?
A lot of the background work has been done; that’s why we’re not reinventing the wheel. We’re getting the car moving. The world is somewhere between stalled and making very slow progress in these two areas — despite the substantial need, benefits and clear pathway forward. So what we will have the latitude to do is work strategically to accelerate and scale up progress. And we’re not doing this alone. We’ll be doing it with a coalition of partners who have global reach — as does Vital Strategies.
How large an organization do you expect this will be?
I want to be lean and mean. Or lean and nice. Basically I want to keep the organization quite small in New York and focus on support at the country level. So I would anticipate Resolve itself will only have 10 or 15 staff here. We will also embed staff in various places and as needed, start country offices. However, we’re part of Vital Strategies. Vital Strategies has around 300 staff working in more than 60 countries. … So it’s a great fit as an organization.
How does creating a new program or initiative get that car into gear?
Part of the reason the car isn’t moving very fast right now is that some of the technical guidance is extremely cumbersome. And it’s not ready to be scaled up massively. So working with WHO and CDC, we will establish technical guidance and package and tools that a country can use to rapidly scale up these programs.
The lack of hypertension treatment is not acceptable. How is it acceptable that 86 percent of people in the world who have an easily treatable condition are being subjected to stroke, heart attack, amputation, and kidney failure, which are incredibly expensive to care for, just because we haven’t treated them? How is it acceptable that most countries in the world can’t quickly identify or stop an outbreak, and so they, their neighboring countries and the world are at greater risk?
And part of what has to be done is to establish the expectations for a new normal.