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Feature Profile

Tom Frieden: Bold pioneer of US public health

BMJ 2009; 339 doi: (Published 08 September 2009) Cite this as: BMJ 2009;339:b3565
  1. Karen McColl, freelance writer
  1. karen{at}

    As the US continues to debate health reforms, Tom Frieden, head of the CDC, tells Karen McColl that prevention must be the priority

    Health could hardly have been higher on the US agenda when Tom Frieden started his job as director of the Centers for Disease Control and Prevention (CDC). Swine flu, healthcare reform, and the federal stimulus package were just three of the issues in his in-tray on his first day on 8 June. The high profile of each of these issues, he says, has been “enough to have kept it a very interesting time.”

    Although responsibility for health policy largely rests with individual states, and federal laws are decided in Washington, the CDC has a vital role in facilitating federal, state, and local action. The remit of the Atlanta based agency—with an overall budget of $10.1bn (£6.3bn; €7.1bn) and a staff of over 14 000—covers health promotion, disease prevention, and preparation for new health threats. CDC is also an important player in global health.

    Although Frieden was nominated by President Obama, the appointment did not have to go through the highly political process of senate confirmation. Nonetheless, as former health commissioner for New York, Frieden is well known for his willingness to use the law to control health risks, and placing him at the head of the country’s main public health agency sends a clear signal that the administration intends to take a strong line on health protection.

    Need for change

    Frieden is openly critical of the current public health infrastructure, which he says “has suffered from decades of neglect.” He also criticises a “healthcare infrastructure that is poorly coordinated, has poor information management, and does not focus on prevention.” He sees it as an important priority for …

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