Web EpiMonitor

Focus Is On “Low Hanging Fruit” In Global Health

In contemplating his next career move, former CDC Director Tom Frieden asked himself where and how he could make the most difference, and global public health was his answer. Now, in what appears to be a global public health initiative customized to his experience, skills, and interests, Frieden has been selected to head Resolve To Save Lives, a five year initiative launched this month with 225 million dollars from the Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill & Melinda Gates Foundation .

Two Efforts Under One Initiative

The initiative brings together under one leader efforts to combat both communicable and non-communicable diseases, two very different “families” of public health challenges. Working on such dissimilar threats is something rarely seen before in  launches of new public health initiatives, for example those targeted against tobacco, drug abuse, road accidents, or obesity.

Resolve To Save Lives will tackle heart disease and stroke and infectious disease epidemic prevention. While the approaches to combatting each of these will require very different actions, what they have in common is that proven effective interventions exist to combat both sets of problems, and these interventions are underutilized, especially in low to middle income countries. This is the opportunity Frieden is trying to capitalize on to save 100 million lives over the next thirty years.

According to Resolve, “Both of these issues are at a tipping point. Without significant investment and attention now---millions of preventable deaths will continue to occur and the world will not be safe from the next disease threat.” In short, they represent “low-hanging fruit” in global public health.

Interventions

What are these interventions? For heart disease and stroke, Resolve will work to increase blood pressure control, reduce dietary sodium intake, and eliminate artificial trans fats. To prevent epidemics, Resolve will develop surveillance systems, train more epidemiologists or disease detectives, support public health labs, and develop rapid response teams when outbreaks occur. 

As Frieden told the New York Times in an interview about the new initiative, “why are we only focusing on sodium reduction, trans fats, and blood pressure control? There are other things [such as a Mediterranean diet or increase physical activity] that either work but haven’t been scaled up, or that we don’t know how to do. The Resolve interventions are all actions where evidence exists to demonstrate effectiveness.

Benchmarks

For example, Resolve cites the success in Canada in achieving nearly 70% blood pressure control, the success in Denmark and New York City in eliminating trans fats from foods, and the success in the United Kingdom in decreasing sodium consumption and associated heart disease and stroke. In short, there are public health interventions that have been successfully scaled up and produced measurable impacts in different populations and these have created and these have created benchmark goals that are attractive and achievable for other countries. In short, there is “proof of concept” for the interventions envisaged by Resolve and the entire initiative could be framed as a major push to better translate proven data into action. According to Frieden, “There are proven strategies every country can use to prevent deaths from heart disease, stroke, and epidemics – but progress has been painfully slow…”

Goals for the Initiative

In setting goals for these interventions, Resolve has targeted increasing global control of blood pressure from 12 to 50%, reducing global dietary sodium intake by 30%, and eliminating trans fats completely. In preventing outbreaks, Resolve has understandably not provided the number of epidemics it will seek to prevent or lives it will seek to save, however, the proven valuable activities they will undertake include

• Implement and strengthen disease tracking systems – so that unusual events are noticed and investigated.
• Support laboratory networks – so that new and emerging threats are identified promptly.
• Develop and support “disease detectives” – epidemiologists to track and investigate diseases and outbreaks.
• Develop rapid response teams – to investigate and stop outbreaks, working out of functional emergency operations centers which operate under structured, effective incident management systems.

Resolve will be implemented by a team of global health experts at Vital Strategies, a New York-based global health organization that works in more than 60 countries.

To learn more about the new initiative, visit :
https://www.resolvetosavelives.org/

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