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COVID-19 missteps could be used to help strengthen science and public health, experts say

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Catherine Morrow

The Jan. 9, 2021, issues of JAMA features a Health Policy Viewpoint article authored by three Emory public health experts. 

As the United States continues to lead the world in most coronavirus deaths and cases, leading scientists and public health experts at Emory University say the pandemic is a “clarion call” to examine ways to bolster and modernize systems that support and guide science, technology, and public health in the country.

Writing in the most recent issue of the medical journal JAMA, K.M. Venkat Narayan, MD, Ruth and O.C. Hubert professor of global health at Rollins School of Public Health, James Curran, MD, dean at Rollins, and William Foege, MD, emeritus presidential distinguished professor at Rollins, say the national crisis has “exposed critical weaknesses” in the institutional systems intended to protect and promote personal and public health.

“There have been escalating attacks on science and expert opinion, an intrusion of partisan politics into public agencies, especially the Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA), and absence of national coordination,” the authors say.

“Direct and dangerous partisan political interference” in these agencies, the authors note, has “often discredited science, in general, and the scientific independence and voice, in particular, of these institutions.”

The experts stressed that the current moment presents an opportunity to think boldly for a better future and ensure that eminent federal institutions remain effective guardians of public health. “This will require significant changes to the governance structures of the public health institutions and rebuilding of public trust in science and public health.”

To spur dialogue and potential action, the authors posed a series of questions as well as recommendations for consideration. A few are reproduced below:

  • How can public communication be enhanced so that interventions supported by science are implemented optimally and effectively? How can education be improved to promote deeper societal understanding and knowledge of science and scientific principles to enhance public trust in science?
  • Could a revised governance structure in which the legislative branch, in a bipartisan joint effort with the executive branch offering more oversight of public health agencies such as the CDC and FDA, be more effective than the current system that consists primarily of executive branch oversight?
  • Could a model such as the Federal Reserve be appropriate for the CDC and the FDA? This would permit the directors of science agencies to serve on a term-limited basis that falls outside the presidential election cycle of four years. Such a model also could enable an oversight body, such as an independent advisory board, composed of science and public health experts, business leaders, academic leaders, civic body representatives, and community members. Might a bipartisan independent commission be required to review recent experience and consider options for an effective model?
  • Can programs such as the Global Health and Security Initiative offer collaborative potential to define a new ecosystem for global collaborations in science and in public health? How can transnational nonpolitical bridges such as the World Health Organization be strengthened to foster greater global collaboration in science and in public health?

Apart from the three primary authors, a host of Emory leaders, all members of the National Academies of Sciences, Engineering, and Medicine, also contributed to the commentary.

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