The Honorable Alex M. Azar
Secretary U.S. Department
of Health and Human Services
200 Independence Avenue,
SW
Washington, DC 20201
Dear Secretary Azar,
Our organizations have been directly involved in the fight
against the coronavirus (COVID-19) – from serving on the front lines, to working
with policymakers to make evidence-based decisions, and to collecting and
sharing data. We are deeply concerned about increasing reports of resistance to
evidence-based public health messages and threats to public health leaders and
agencies. Such actions undermine the efforts to protect the health and
well being of America’s residents at a critical juncture when cases of COVID-19
are rising.
At this sentinel moment, we urge you to affirm the invaluable
role of the Centers for Disease Control and Prevention (CDC) and resist any
efforts that would undermine its mission. Similarly, we stand in solidarity
with the local, tribal, and territorial public health agencies as they strive
to provide guidance in how to re-open safely, avoid preventable deaths and
decrease the likelihood of a second major shutdown on the economy.
CDC, state, local, tribal, and territorial public health
staff have been working around the clock for months to respond to the pandemic
and protect the public, while often relying on overworked staff and inadequate
systems that are the result of decades of underfunding.1
The United States spends an estimated $3.6 trillion annually
on health, but less than three percent of that spending is directed toward
public health and prevention.2, 3
And, public health spending as a proportion of total health
spending has been decreasing since 2000 and falling in inflation-adjusted terms
since the Great Recession.4
CDC’s core budget remains inadequate to meet the nation’s
public health needs. While emergency supplemental funding has been critical to
begin to address the immediate COVID needs, robust, sustained, and predictable
funding for its full public health mission is essential to sustain its core
public health activities and work to prevent the next emergency.
Underfunding CDC has a direct impact on the public health
agencies in states and local communities that rely on federal funding from the
CDC. While some funding also comes from state and local sources, federal funds
are critical for states and communities to help reach our national goals of a
safer and healthier population.
Moreover, funds from state and local governments are incredibly
sensitive to economic shifts and are very likely to shrink further as a result
of the current economic outlook. The broad scope of CDC’s work – from chronic
disease to injury prevention to environmental health to emergency preparedness
to infectious disease – is critical. It is not possible to effectively meet the
needs of the American people if that scope is narrowed.
We have seen how many chronic diseases and conditions that
afflict Americans, such as obesity, heart disease and diabetes, have increased
the risk of hospitalization and death from COVID-19. The pandemic has also
starkly highlighted the unacceptable health disparities related to racism and
discrimination which can only be addressed with a sweeping, rather than a
narrow, health focus.
CDC, along with the White House, the Department of Health and
Human Services, state and local health departments have made some missteps in
their response to COVID-19 which should be acknowledged and learned from. After
the global pandemic we must work collaboratively to modernize CDC and the
entire public health system while at the same time ensuring it has the funding
and support necessary to do so.
Nonetheless, CDC continues to be the world’s premiere public
health institution and should be treated as such during this pandemic. It is a
scientific organization that functions best as an apolitical agency trusted to
guide the strategy of our nation to be healthier and safer. We must amplify the
unfettered voice of CDC, not stifle it.
The core mission of the CDC is clear, and it is replicated in
every state, local, tribal and territorial public health agency: prevent
illness and injury and save lives. Now more than ever we need them to
accomplish their mission. Secretary Azar, the health of all Americans is at
stake. We urge you to speak up and amplify the critical role of CDC and that of
all public health agencies during this monumental crisis.
Sincerely,
For the letter and list of nearly 350 public
health organizations, advocacy groups, and local health departments that petitioned
Trump on July 1, 2020, click here.
1 Farberman, RK, McKillop M, Lieberman DA, et al. The Impact
of Chronic Underfunding on America’s Public Health System: Trends, Risks, and
Recommendations, 2020. https://www.tfah.org/reportdetails/publichealthfunding2020/
(accessed June 30, 2020).
2 National Health Expenditures Accounts. In Centers for
Medicare & Medicaid Services, 2018.
https://www.cms.gov/researchstatistics-data-and-systems/statistics-trendsandreports/nationalhealthexpenddata/nationalhealthaccountshistorical
(accessed March 14, 2020).
3 Himmelstein DU and Woolhandler S. “Public Health’s Falling
Share of US Health Spending.” American Journal of Public Health, 106(1): 56-57,
2016. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302908
(accessed March 14, 2020).
4 Ibid.
This letter was linked in an article by Politico, July 7, 2020.
Azar’s ties to Big Pharma:
ReplyDelete“…Azar had stepped down from his position as president of pharmaceutical giant Eli Lilly and Company’s US division, where he was essentially in control of the company’s dealings with the US drug market. When Azar joined the company in 2007 (he began as its top lobbyist and senior vice president of corporate affairs and communications), the price of the group’s insulin lispro injection, Humalog, was just $74. In the decade that followed, its rising price correlated with Azar’s rise to prominence—it jumped nearly 300%. During Azar’s 5-year tenure as the pharma company’s US president, Humalog would see its steepest increases, climbing from around $125 in 2012 to more than $250 at the point of Azar’s departure in 2017. In 2014, the drug increased 20.8% in price, followed by a 16.9% uptick in 2015 and another 7.5% in 2016…
“Many doctors interviewed by MD Magazine® shared doubts that a prior pharmaceutical company president could successfully address ever-climbing medication costs in the United States. Eugene Gu, MD, a surgical resident at Vanderbilt University Medical Center, said that Azar’s industry tenure will spoil his ability to deliver as HHS head.
“Gu described Azar as someone with ‘the temperament of a man who does not care for the lives of millions of Americans.’ He alleged that Azar used his experience as deputy secretary of HHS to obtain his later position with Eli Lilly, where he ‘raised the prices of many drugs, including [that of] lifesaving insulin,’ Gu said. ‘It’s a huge conflict of interest,’ he continued. ‘Who’s to say he doesn’t have plans to return to the pharma industry after his current role as secretary of HHS is over? He would likely want to further the interests of the pharmaceutical industry so that he remains in their good graces and continues on the gravy train.’…”
(https://www.mdmag.com/medical-news/azar-the-future-of-hhs-drug-prices-and-health-care)