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Covid-19, monkeypox and infant formula shortages are just some of the challenges the federal government has faced over the past several months and years. Despite the federal response to these challenges, criticism of agencies such as the Centers for Disease Control and Prevention and the Food and Drug Administration has come from both parties during the Trump and Biden administrations.
Several recommendations have recently been made to facilitate the role of federal agencies; However, many of these can cause unexpected results. It is important that any reforms prioritize improving leadership and coordination within the federal bureaucracy without eliminating critical missions and roles.
first, Reports An internal review of the CDC’s response to COVID-19 revealed concerns such as a rigid funding structure, lack of authority to collect public health data, and overly lengthy review processes for scientific guidance. The CDC has also been criticized during the pandemic for communicating its scientific guidance in a way that takes into account real-world implications. Possible solutions to these problems include seeking Senate confirmation of the CDC director to increase accountability, giving the CDC the authority to collect core public health data, and identifying ways to quickly recoup emergency funding.
One idea that should not be considered is to drop “prevention” from the CDC’s name and focus on non-communicable diseases, making it just an infectious disease response agency. As we know, the majority of deaths in America are caused by preventable chronic diseases. 90 percent About $4.1 trillion of the nation’s annual health care costs go to people with chronic and mental health conditions. Not only is CDC’s mission central to promoting health and preventing disease on a large scale, but its work ensures that Americans are more resilient to emergencies like COVID-19. The latest Research An estimated two-thirds of Covid-19 hospitalizations are due to obesity, high blood pressure, diabetes and heart failure – all preventable chronic diseases.
Second, it’s the FDA. It is reported Reorganize the food security program after the national shortage of infant formula and Investigations Failure to ensure product, baby food and water safety. Solutions in a A recent US Senate hearing It includes a new leadership structure that unifies food programs, new models of public-private partnerships, and resources to help recruit and retain more staff.
A less-than-ideal idea would be to remove “food” from the FDA’s mission, which has been monitoring food safety for nearly a century, to create a new agency (and thus a new silo). Instead, it’s a better choice to ensure that the FDA starts prioritizing not just food safety, but healthy food as well. As for the latter, aggressively combating excess sodium and added sugars when specifying the word “healthy” on food labels is now the nation’s poor diet, a priority for the agency. leading risk factor For death, by passing smoking. Along with tobacco, which the FDA regulates, the agency must fulfill its primary mission as a public health agency by regulating these two risk factors for disease.
Third, Congress created the position and office of the Assistant Secretary for Preparedness and Response (ASPR) at the Department of Health and Human Services (HHS) 15 years ago. However, HHS secretaries have not always authorized ASPR to act on its behalf or provide clear direction to HHS agencies. The Biden administration has. proposed that To move ASPR from an office supporting the Secretary to an agency similar to the CDC, FDA, and others, however, would not solve this lack of coordination and, alternatively, risks creating another.
The best idea is for Congress and H.H.S. Clarifying and Strengthening Secretary ASPR’s Leadership Roles and Responsibilities During the Federal Response to Pandemics Advice Recently released by the Bipartisan Policy Center’s (BPC) Future of Health Task Force. Enhancing the office’s hiring and contracting authorities should also be included. The BPC task force recommended that ASPR’s leadership be consolidated within HHS, with the creation of a new White House Deputy National Security Adviser to coordinate, direct, and be accountable for all biodefense preparedness and operational response efforts across all federal departments and agencies.
Finally, one policy objective that we should pursue, especially in light of our experience with Covid-19, is to strengthen our country’s public health infrastructure so that it has the capacity to respond to various challenges. In addition to renewed federal leadership, this requires sustained long-term investments in states and localities.
Up to this point, a Advice At H.H.S. In order to establish a position such as the Under Secretary for Public Health, the Commonwealth Fund Commission should look favorably on the National Public Health System. This position helps oversee and coordinate the development of the national public health system with federal agencies, states, localities, tribes, and territories. Considering the importance of ensuring program alignment and budget transparency, the Commission recommends that H.H.S.
With the 2023 midterm elections and the 118th Congress, calls for reform and government oversight of the nation’s federal public health structure are likely to increase. It is important to scrutinize proposals not only for their merits but also for unintended consequences. As the federal government contemplates reorganization or relocation, it must focus on strengthening its leadership capacity to respond to all public health challenges in the immediate and long term so that we can bring about a healthy nation.
Anand Parekh, MD, MPH, is chief medical adviser at the Bipartisan Policy Center and deputy assistant secretary for health at the Department of Health and Human Services.
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