The Formula for Better Health: How to Save Millions of Lives

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2:15The U.S. government shutdown and its impact on public health has started to set in. Federal health agencies began operating on a much smaller scale. More than 32 ,000 workers were furloughed at HHS. The CDC is open, but communications to state and local health departments around prevention of HIV and opioid overdoses has stopped.

2:32Carol Massar:Infectious disease surveillance data is still being compiled, but analysis and reporting to the public will stop. The U.S. is currently in a record-breaking measles outbreak, and the CDC reports cases every Wednesday. Dr. Tom Frieden is former director of the CDC, also former commissioner of the New York City Health Department. He's also the president and CEO of Resolve to Save Lives. It's a global health organization which funds epidemic preparedness and other health initiatives in countries throughout the world. We should note, Carol, that Resolve to Save Lives has received funding from Bloomberg Philanthropies, the philanthropic arm Bloomberg LP, the parent company of Bloomberg Radio.

3:08And Dr. Frieden is a longstanding partner of Bloomberg Philanthropies.

3:12Carol Massar:He's also got a new book out. It's called The Formula for Better Health, How to Save Millions of Lives, Including Your Own. Dr. Frieden joins us from New York. Dr. Frieden, great to have you here with Tim and me on Bloomberg Businessweek Daily. What is this moment in public health? This is an unprecedented time. Public health is under assault. And what that means for each of us is that our health is less safe and secure. Whether there's food contamination in food at the local supermarket or an outbreak of an infectious disease or a new toxin in the environment, our defenses are dead. down. We're disarming against a world of health threats.

3:53And that puts all of us and businesses on a less safe footing.

3:58Carol Massar:So if the global pandemic that we all lived through, not everyone lived through, unfortunately, as we all know, in 2020, and for years, you know, it took a while to come out of it, and some are still dealing with it. If that happened today, would you say we would have a much more dire situation? We're definitely less prepared than we were before the pandemic, and we weren't well prepared then. The book that I've just released this week, and I should say all of the proceeds from that book will go to support programs that support health around the world, outlines an approach. It's proven. It has saved millions of lives, and it can save millions more.

4:45The approach is see, believe, create. See the health threats and the path to progress. Believe that we can make progress toward a healthier future and then work systematically to create that future. And the shutdown and more broadly, the attacks on public health that we have seen over the last nine to 10 months are undermining all three of those components. We're losing our ability to see health threats. We're losing confidence that we can do great things in this country and stop cancer and heart disease with real interventions, not performative stuff. And we're risking the creation of a healthier future.

5:22But there's still plenty of hope. We can't replace the federal government, but state governments, local governments, organizations around the world, academics can do a lot to protect and improve health.

5:33Carol Massar:There's where I wanted to push back, because I think, you know, there are folks like how many stories have we done over the years, over the decades, how much America spends on health care developed nation, and yet our health outcomes are not great compared to other developed nations. And in terms of what they spend. Yeah, but that's health care, Carol. That's not public health. That's health care. We have a wasteful health care system, and we have an underinvested public health system. Interesting. Because you know what some will say, that sometimes you have to disrupt something to even make it even more productive and better.

6:07Yeah, in business that may work. In government, if you want to make something better, you make it better. You don't destroy it. And what we're seeing now is destruction, just wanton destruction. Half of CDC's National Center disbanded, more than 2 ,000 staff with no rhyme or reason, basically discharged. You know, they're saying they want a healthy America. They're saying they want to take on chronic disease. But they've ended the chronic disease prevention programs at CDC that led the progress against things like tobacco. And there has been progress. We've seen tobacco use rates fall by more than 75 % over the last decades.

6:43We've seen big reductions in birth defects, for example, through CDC action on things like folate supplementation and folate fortification. So there's a lot of progress that's at risk and more progress that's not going to happen unless we use a focused approach to see the path forward, to systematically work. And I agree, we shouldn't just put back what's there. We need to build forward to a more connected, faster, more practical public health and health care system that really delivers results. Our health care system is a disgrace. We spend four and a half trillion dollars on health care in this country, and we have a worse health status than any other high income country for twice the per capita spending.

7:28But that's not overinvestment in public health. That's poor investment in health care. Then how do we bridge these things? How do we create better outcomes here in the United States, given how much money we spend on health care? Because even though you made that distinction to us and you made that distinction to our audience, I don't think Americans think of these things in different ways. They think health, they think health care. They probably lump everything together. Prioritize, simplify, communicate, and overcome barriers. That's the create part of the formula to save millions of lives. And what I mean by that is whether it's in public health where simple things like taxing tobacco and sugary drinks or eliminating pollution of PM2.5 and PFAS that you were just talking about that still contaminates half of the water in the U.S., That's a public health thing and everyone benefits from that.

8:21Or in healthcare, focus on what really matters. I'll give you the single most important thing, and maybe this is the most important personal health thing from the book as well, blood pressure. Everyone says, oh, I know about it. Actually, healthy blood pressure is less than 120 over 80. Even with the target of 140 over 80, the U.S. healthcare system for more than$10 ,000 a person doesn't get that right even half the time. More than half of people in this country with high blood pressure don't have it controlled. And because of that, they have heart attacks, strokes, kidney failure. That's expensive.

8:54We need to fix health care. And we're going to do that by changing the way we pay for health care so that it pays for health care systems to prevent disease. Right now, it pays for them not to prevent disease. I will point out on the tobacco side of things, Dr. Frieden, a proposed ban on menthol cigarettes and flavored cigars was withdrawn by the Trump administration. Carol, this was just four days into his second term. So this was something that had been proposed earlier. And Tim, the whole Tim, the entire CDC unit, hundreds of staff that do tobacco control were all fired. They run ad campaigns.

9:28They support state quit lines. This is not stopping chronic disease. This is opening the door for chronic disease and saying this is not deregulation. It's open season on our lungs. Dr.

9:40Carol Massar:Frieda, I wonder what you think about the obesity drugs, the GLP-1 drugs. Do you think that wider use of them would bring big, big, big societal benefits? Are you concerned about potential side effects, maybe longer term, or the societal impact of massive reliance on what is a prescriptive medicine? It's not either or. We can tax soda and scale up use of effective drugs. I will say the GLP-1 agonists are big breakthrough drugs. They're remarkably effective, but they're not quite ready. Two-thirds of people stop taking them within a year. They're injections. They have nasty side effects. So over the coming years, I think we'll see pill forms of those.

10:22I think we'll see them more tolerable by people. And they do have major benefits, not just on weight, but on many other outcomes, as do some of the other new categories of drugs, the SGLT2 inhibitors. There's some great new drugs. There's reasons to be optimistic. We have better tools to support health than ever in human history. But we need to get away from fictions, from misinformation, from disinformation, from simplistic stuff that we see coming out of this administration to seeing the actual threats, seeing the path to progress, systematically strengthening belief by scaling up programs that work and working together to create a healthier future.

11:03You know, one thing that we've talked quite a bit about over the last not even two weeks at this point is the president as a messenger when it comes to health. And I think of the press conference that he gave last week about about Tylenol and pregnant women taking Tylenol. And I'm just wondering how you view him as a messenger for public health. I really hope people will get their medical advice from doctors and nurse practitioners, not from politicians and trial lawyers. There were parts of what the president and Mr. Kennedy said that weren't wrong, but that was awash in a sea of falsehoods and misinformation.

11:41It is certainly the case that we say to all pregnant women, avoid medications unless absolutely necessary. On the other hand, fever has a lot of bad implications for the baby, and pain makes pregnancy much less successful. So you really want to have your medical advice from doctors. Tylenol is the safest of all of the fever-reducing, pain-reducing medications. Safer than aspirin, safer than ibuprofen or other non-steroidals. So don't get your medical advice from trial lawyers, and don't get it from people who are selling you anything. And as I said, the proceeds from this book, The Formula for Better Health, will all go to supporting health programs around the world.

12:23What I try to do is cut through the hype, the sloppy thinking, the grifting to what really matters. And, you know, here's one thought for you. A brisk walk outdoors 30 minutes, four days a week will do more good for your health than any pill.

12:39Carol Massar:Amen. I got to tell you, and I know we all got to work and I love where I work. It's a great place. But, man, I was on vacation basically outside for two weeks straight and I've never felt so good in my life. So I hear you. Hey, listen, we just have about 45 minutes. You are former director of the CDC. If you were current director of the CDC, your book is The Formula for a Better Health. What would be your formula for the CDC we need in today's environment? Build forward, more connected with state and local health departments, faster, addressing concerns that people feel, doing programs that people can see and appreciate, working together with alliances to address the biggest problems, the biggest threats to health, seeing those threats, creating steady progress, and showing progress.

13:30That's really important. And listening to what people are saying and communicating more effectively.

13:35Carol Massar:All right, got to leave it there. Dr. Frieden, thank you so much. Former director of the CDC and also president and CEO of Resolve to Save Lives. We should note that Resolve to Save Lives has received funding from Bloomberg Philanthropy is his book, The Formula for Better Health.

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