Tom Frieden

Tom Frieden
Director of the Centers for Disease Control and Prevention
In office
2009–2017
President Barack Obama
Preceded by Julie Gerberding
Succeeded by Brenda Fitzgerald
New York City Health Commissioner
In office
2002–2009
Mayor Michael Bloomberg
Personal details
Born 1960 (age 56–57)
Education

Thomas R. Frieden, M.D., M.P.H is an American infectious disease expert and the former director of the U.S. Centers for Disease Control and Prevention (CDC) and acting administrator of the Agency for Toxic Substances and Disease Registry from 2009 to 2017. He was appointed by President Barack Obama.[1] He previously served as commissioner of the New York City Department of Health and Mental Hygiene (DOHMH) from 2002 to 2009.

Education

Frieden graduated from Oberlin College (B.A., 1982), Columbia University College of Physicians and Surgeons (M.D., 1986), and Columbia University Mailman School of Public Health (M.P.H., 1985). He completed a residency in internal medicine at Columbia-Presbyterian Medical Center and a sub-specialty fellowship in infectious diseases at Yale School of Medicine and Yale–New Haven Hospital.

Early career

Frieden's work on tuberculosis in New York City, initially as an Epidemic Intelligence Service officer assigned by CDC and later as assistant commissioner of health and director of the DOHMH Bureau of Tuberculosis Control, fostered public awareness and helped improve city, state and federal public funding for TB control.[2][3] The epidemic was controlled rapidly, reducing overall incidence by nearly half and cutting multidrug-resistant tuberculosis by 80%.[4] The city's program became a model for tuberculosis control nationally and globally.[5][6]

From 1996 to 2002, Frieden was based in India, assisting with national tuberculosis control efforts. As a medical officer for the World Health Organization on loan from the CDC, he helped the government of India implement the Revised National Tuberculosis Control Program.[7][8][9][10] The program's 2008 status report estimated that the nationwide program resulted in 8 million treatments and 1.4 million lives saved.[11] While in India, Frieden worked to establish a network of Indian physicians to help India's state and local governments implement the program[12] and helped the Tuberculosis Research Center in Chennai, India, establish a program to monitor the impact of tuberculosis control services.[13][14]

New York City Health Commissioner

Frieden served as Commissioner of Health of the City of New York from 2002 to 2009. At the time of his appointment, the agency employed 6,000 staff and had an annual budget of $1.6 billion.[15]

Inititiatives

Upon his appointment as Commissioner of Health, Frieden made tobacco control a priority,[16] resulting in a rapid decline[17] after a decade of no change in smoking rates. Frieden established a system to monitor the city's smoking rates, and worked with New York City Mayor Michael R. Bloomberg to increase tobacco taxes, ban smoking in workplaces including restaurants and bars, and run aggressive anti-tobacco ads and help smokers quit.[18] The program reduced smoking prevalence among New York City adults from 21.6% in 2002 to 16.9% in 2007 – a change that represented 300,000 fewer smokers and could prevent 100,000 premature deaths in future years.[17][19] Smoking prevalence among New York City teens declined even more sharply, from 17.6% in 2001 to 8.5% in 2007, which was less than half the national rate.[20] The workplace smoking ban prompted spirited debate before it was passed by the New York City Council and signed into law by Mayor Bloomberg.[21] Over time, the measure gained broad acceptance by the public and business community in New York City.[22][23] New York City's 2003 workplace smoking ban followed that of California in 1994. Frieden supported increased cigarette taxes as a means of forcing smokers to quit, saying "tobacco taxes are the most effective way to reduce tobacco use."[24] He supported the 62-cent federal tax on each cigarette pack sold in the United States, introduced in April 2009.[25] One side effect of the increased taxes on tobacco in New York was a large increase in cigarette smuggling into the state from other states with much lower taxes, such as Virginia. The Tax Foundation estimated that "60.9% of cigarettes sold in New York State are smuggled in from other states".[26] In addition, some New Yorkers began to make their own cigarettes, and tobacco trucks were even hijacked. A 2009 Justice Department study found that "The incentive to profit by evading payment of taxes rises with each tax rate hike imposed by federal, state, and local governments".[27]

Frieden also introduced Take Care New York, the city's first comprehensive health policy. This program targeted ten leading causes of preventable illness and death for concerted public and personal action.[28][29] By 2007, New York City had made measurable progress in eight of the ten priority areas.[30]

As Health Commissioner, Frieden sought to fight HIV and AIDS with public health principles used successfully to control other communicable diseases.[31] The most controversial aspect of this strategy was a proposal to eliminate separate written consent for HIV testing. He believed the measure would encourage physicians to offer HIV tests during routine medical care,[32] as the CDC recommended.[33] Some community and civil liberties advocates fought this legislation, arguing it would undermine patients' rights and lead eventually to forced HIV testing.[34][35] In 2010, New York State passed a new law that eased the requirement for separate written consent in some circumstances.[36] On February 14, 2007, the New York City Department of Health and Mental Hygiene introduced the NYC Condom,[37][38] prompting Catholic League president Bill Donohue to respond, "What's next? The city's own brand of clean syringes?"[39] More than 36 million condoms were given away by the program in 2007.[40]

Frieden worked to raise awareness about diabetes in New York City, particularly among pregnant women,[41] and established an involuntary, non-disclosed hemoglobin A1C diabetes registry that tracks patients' blood sugar control over several months and report that information to treating physicians in an effort to help them provide better care.[42][43]

The New York City Board of Health's decision to require laboratories to report A1C test results generated a heated debate among civil libertarians, who view it as a violation of medical privacy and an intrusion into the doctor-patient relationship. Although patients may elect not to receive information from the program, there is no provision enabling patients to opt out of having their glycemic control data entered in the database.[44][45]

During Frieden's tenure as Commissioner, the Health Department expanded the collection and use of epidemiological data,[46] launching an annual Community Health Survey[47] and the nation's first community-based Health and Nutrition Examination Survey.[48][49]

Director of CDC and Administrator of the Agency for Toxic Substances and Disease Registry

On May 15, 2009, the White House and the Department of Health and Human Services named Dr. Frieden the 16th director of the Centers for Disease Control and Prevention and administrator of the Agency for Toxic Substances and Disease Registry; he assumed his position on June 8, 2009, from the acting head, Dr. Richard E. Besser.[50] Frieden resigned effective January 20, 2017.

"On announcing Frieden’s appointment, President Obama called him "an expert in preparedness and response to health emergencies" who in seven years as New York City's health commissioner was "at the forefront of the fight against heart disease, cancer and obesity, infectious diseases such as tuberculosis and AIDS, and in the establishment of electronic health records."[1] Frieden had previously worked for the CDC from 1990 to 2002 as an Epidemic Intelligence Service Officer in New York City and then assigned to India as a Medical Officer as part of CDC's tuberculosis control program.

Ebola epidemic

Frieden is decontaminated after visiting Ebola treatment unit in Liberia, August 2014

Frieden was a prominent figure in the US and global response to the West African outbreak of Ebola. His visits to West Africa beginning in August 2014 and a September 2014 CDC analysis projecting that the Ebola epidemic would increase exponentially to infect more than 1 million people within four months[51] prompted him to press for an international surge response.[52] At the peak of the response, CDC maintained approximately 200 staff per day in West Africa and approximately 400 staff per day at its Atlanta headquarters dedicated to the response; overall, approximately 1,900 CDC staff deployed to international and U.S. locations for approximately 110,000 total work days, and more than 4,000 CDC staff worked as part of the response.[53] In a Congressional hearing on October 16, 2014, Frieden was questioned for his handling of the Ebola crisis following the spread of the disease to two nurses from the original patient in the US.[54] The previous day, the response of the CDC to the crisis led Rep. Tom Marino (R-PA) to call for Frieden's resignation,[55] although others rallied to his defense.[56][57]

Publications

Awards

References

  1. 1 2 Wilgoren, D. "Obama Chooses NYC Health Chief to Head CDC". Washington Post, May 16, 2016. Retrieved 31 January 2017.
  2. ↑ Lobato, M.N.; Wang, Y.C.; Becerra, J.E.; Simone, P.M.; Castro, K.G. (2006). "Improved Program Activities Are Associated with Decreasing Tuberculosis Incidence in the United States". Public Health Reports. 121 (2): 108–115. PMC 1525263 Freely accessible. PMID 16528941.
  3. ↑ Leff, D.R.; Leff, A.R. (November 1, 1997). "Tuberculosis Control Policies in Major Metropolitan Health Departments in the United States. VI. Standard of Practice in 1996". American Journal of Respiratory and Critical Care Medicine. 156 (5): 1487–1494. PMID 9372665. doi:10.1164/ajrccm.156.5.9704105.
  4. ↑ TB Annual Summary (PDF). New York: New York City Department of Health and Mental Hygiene. 2015. p. 22. Retrieved 24 January 2017.
  5. ↑ World Health Organization Tuberculosis Programme (1995). "New York City's Success Story". Stop TB at the Source. Geneva: World Health Organization. ISBN 978-0-11-951529-9. OCLC 181876135.
  6. ↑ Steinhauer, Jennifer (February 14, 2004). "Gladly Taking The Blame For Health In the City". New York Times. Retrieved July 8, 2009.
  7. ↑ Drazen J.M. (October 2002). "A milestone in tuberculosis control". New England Journal of Medicine. 347 (18): 1444. PMID 12409549. doi:10.1056/NEJMe020135.
  8. ↑ Khatri, G.R.; Frieden, T.R. (October 2002). "Controlling tuberculosis in India". New England Journal of Medicine. 347 (18): 1420–1425. PMID 12409545. doi:10.1056/NEJMsa020098.
  9. ↑ Udwadia, Z.F.; Pinto, L.M. (2007). "Review series: the politics of TB: the politics, economics and impact of directly observed treatment (DOT) in India". Chronic Respiratory Disease. 4 (2): 101–106. PMID 17621578. doi:10.1177/1479972307707929.
  10. ↑ Chauhan, L.S.; Tonsing, J. (2005). "Revised National TB Control Programme in India". Tuberculosis. 85 (5–6): 271–276. PMID 16253562. doi:10.1016/j.tube.2005.08.003.
  11. ↑ TB India 2008: RNTCP Status Report: I am Stopping TB. New Delhi: Ministry of Health and Family Welfare. March 2008. p. 3. ISBN 81-902652-3-7. Retrieved July 8, 2009.
  12. ↑ Frieden, T.R.; Khatri, G.R. (September 2003). "Impact of national consultants on successful expansion of effective tuberculosis control in India". International Journal of Tuberculosis and Lung Disease. 7 (9): 837–841. PMID 12971666.
  13. ↑ Subramani, R.; Radhakrishna, S.; Frieden, T.R.; et al. (August 2008). "Rapid decline in prevalence of pulmonary tuberculosis after DOTS implementation in a rural area of South India". International Journal of Tuberculosis and Lung Disease. 12 (8): 916–920. PMID 18647451.
  14. ↑ Narayanan, P.R.; Garg, R.; Santha, T.; Kumaran, P.P. (2003). "Shifting the Focus of Tuberculosis Research in India". Tuberculosis. 83 (1–3): 135–142. PMID 12758203. doi:10.1016/S1472-9792(02)00068-9.
  15. ↑ Farley, Tom (2015). Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives. New York: W.W. Norton. p. 8. ISBN 978-0393071245.
  16. ↑ Steinhauer, Jennifer (February 15, 2002). "Commissioner Calls Smoking Public Health Enemy No. 1 and Asks Drug Firms for Ammunition". New York Times. Retrieved July 8, 2009.
  17. 1 2 Centers for Disease Control and Prevention (CDC) (June 2007). "Decline in smoking prevalence – New York City, 2002–2006". Morbidity and Mortality Weekly Report. 56 (24): 604–608. PMID 17585290.
  18. ↑ Frieden, T.R.; Mostashari, F.; Kerker, B.D.; Miller, N.; Hajat, A.; Frankel, M. (June 2005). "Adult Tobacco Use Levels After Intensive Tobacco Control Measures: New York City, 2002–2003". American Journal of Public Health. 95 (6): 1016–1023. PMC 1449302 Freely accessible. PMID 15914827. doi:10.2105/AJPH.2004.058164.
  19. ↑ "Michael Bloomberg and Bill Gates Join to Combat Global Tobacco Epidemic" (Press release). Bill & Melinda Gates Foundation. July 23, 2008. Retrieved July 8, 2009.
  20. ↑ The Lancet (January 2008). "New York City's bold antitobacco programme". Lancet. 371 (9607): 90. PMID 18191665. doi:10.1016/S0140-6736(08)60078-1.
  21. ↑ Chang, C.; Leighton, J.; Mostashari, F.; McCord, C.; Frieden, T.R. (August 2004). "The New York City Smoke-Free Air Act: second-hand smoke as a worker health and safety issue". American Journal of Industrial Medicine. 46 (2): 188–195. PMID 15273972. doi:10.1002/ajim.20030.
  22. ↑ Cooper, Michael (October 23, 2003). "Poll Finds Smoking Ban Popular". New York Times. Retrieved 8 July 2009.
  23. ↑ Rutenberg, Jim; Lily Koppel (February 6, 2005). "In Barrooms, Smoking Ban Is Less Reviled". New York Times. Retrieved July 8, 2009.
  24. ↑ Farley, Tom (2015). Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives. New York: W.W. Norton. pp. 23–38. ISBN 978-0393071245.
  25. ↑ Jonsson, Patrik (November 17, 2009). "Federal and state governments look to smokers for more tax revenue: Though they hit poor Americans hardest, stiff taxes on tobacco can reduce healthcare costs by billions". Christian Science Monitor. Retrieved August 8, 2010.
  26. ↑ Smith, Aaron (January 10, 2013). "60% of cigarettes sold in New York are smuggled: report". CNN Money. Retrieved December 4, 2014.
  27. ↑ Mathias, Christopher (April 3, 2014). "Inside New York City's Dangerous, Multimillion-Dollar Cigarette Black Market". Huffington Post. Retrieved December 4, 2014.
  28. ↑ "Cause of Death or Illness, New York City, 2002, and Amenability to Intervention". Take Care New York: A Policy for a Healthier New York City. New York City Department of Health and Mental Hygiene. March 2004. pp. 57–61. Retrieved July 9, 2009.
  29. ↑ Pérez-Peña, Richard (March 24, 2004). "City sets goals for the health of New Yorker". New York Times. Retrieved July 8, 2009.
  30. ↑ Take Care New York: A Policy for a Healthier New York City (Fourth Year Progress Report) (PDF). New York City Department of Health and Mental Hygiene. December 2008. pp. 2–5. Retrieved January 31, 2017.
  31. ↑ Frieden, T.R.; Das-Douglas, M.; Kellerman, S.E.; Henning, K.J. (December 2005). "Applying Public Health Principles to the HIV epidemic". New England Journal of Medicine. 353 (22): 2397–2402. PMID 16319391. doi:10.1056/NEJMsb053133.
  32. ↑ Mandavilli, A. (April 2006). "Profile: Thomas Frieden". Nature Medicine. 12 (4): 378. PMID 16598275. doi:10.1038/nm0406-378.
  33. ↑ Branson, B.M.; Handsfield, H.H.; Lampe, M.A.; et al. (September 2006). "Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings". Morbidity and Mortality Weekly Report. 55 (RR–14): 1–17; quiz CE1–4. PMID 16988643.
  34. ↑ Chan, Sewell (December 25, 2006). "Rifts Emerge on Push to End Written Consent for H.I.V.Tests". New York Times. Retrieved July 9, 2009.
  35. ↑ Fairchild, A.L.; Alkon, A. (August 2007). "Back to the future? Diabetes, HIV, and the boundaries of public health". Journal of Health Politics, Policy and Law. 32 (4): 561–593. PMID 17639012. doi:10.1215/03616878-2007-017.
  36. ↑ "HIV Testing Is Now a Routine Part of Health Care in New York" (Press release). New York City Department of Health and Mental Hygiene. September 1, 2010. Retrieved February 8, 2011.
  37. ↑ Chan, Sewell (February 15, 2007). "A New Condom in Town, This One Named 'NYC'". New York Times. Retrieved July 8, 2009.
  38. ↑ "Health Department Launches The Nation's First Official City condom" (Press release). New York City Department of Health and Mental Hygiene. February 14, 2007. Retrieved July 8, 2009.
  39. ↑ "NYC-Branded Condoms Are a Big Apple First". Gothamist. Retrieved October 13, 2014.
  40. ↑ "Health Department Releases New NYC Condom Wrapper" (Press release). New York City Department of Health and Mental Hygiene. February 13, 2008. Retrieved July 8, 2009.
  41. ↑ Kleinfield, N.R. (February 22, 2006). "City to Warn New Mothers of Diabetes Risk". New York Times. Retrieved July 9, 2009.
  42. ↑ Steinbrook R. (February 2006). "Facing the Diabetes Epidemic – Mandatory Reporting of Glycosylated Hemoglobin Values in New York City". New England Journal of Medicine. 354 (6): 545–548. PMID 16467539. doi:10.1056/NEJMp068008.
  43. ↑ Bloomgarden, ZT (2006). "A1C in New York City". Medscape Diabetes & Endocrinology. Retrieved 1 February 2017.
  44. ↑ Goldman, J.; Kinnear, S.; Chung, J.; Rothman, D.J. "New York City's Initiatives on Diabetes and HIV/AIDS: Implications for Patient Care, Public Health, and Medical Professionalism". American Journal of Public Health. 98 (5): 807–813. PMC 2374815 Freely accessible. PMID 18381989. doi:10.2105/AJPH.2007.121152.
  45. ↑ Frieden T.R. (September 2008). "New York City's Diabetes Reporting System Helps Patients And Physicians". American Journal of Public Health. 98 (9): 1543–1544; author reply 1544. PMC 2509589 Freely accessible. PMID 18633070. doi:10.2105/AJPH.2008.142026.
  46. ↑ Frieden, TR; Bassett, MT; Thorpe, LE; Farley, TA. "Public health in New York City, 2002–2007: Confronting Epidemics of the Modern Era". International Journal of Epidemiology. 37 (5): 966–977. PMID 18540026. doi:10.1093/ije/dyn108. Retrieved 31 January 2017.
  47. ↑ "Community Health Survey". New York City Department of Health and Mental Hygiene. February 2009. Retrieved July 9, 2009.
  48. ↑ "NYC HANES Datasets and Related Documentation". New York City Department of Health and Mental Hygiene. Retrieved July 9, 2009.
  49. ↑ Thorpe, L.E.; Gwynn, R.C.; Mandel-Ricci, J.; et al. (July 2006). "Study Design and Participation Rates of the New York City Health and Nutrition Examination Survey, 2004". Preventing Chronic Disease. 3 (3): A94. PMC 1637802 Freely accessible. PMID 16776895.
  50. ↑ "President Obama Appoints Dr. Thomas Frieden as CDC Director". The White House. May 15, 2009.
  51. ↑ Meltzer, Martin. "Estimating the Future Number of Cases in the Ebola Epidemic – Liberia and Sierra Leone, 2014–2015" (PDF). cdc.gov. MMWR. Retrieved January 6, 2017.
  52. ↑ "Ebola outbreak: 'We need action now,' says CDC director Tom Frieden". CBC News. September 2, 2014. Retrieved January 7, 2017.
  53. ↑ Bell, Beth. "CDC's Response to the 2014–2016 Ebola Epidemic – West Africa and United States" (PDF). cdc.gov. MMWR. Retrieved January 6, 2017.
  54. ↑ Tavernise, Sabrina (October 16, 2014). "Congress Scrutinizes Handling of Ebola Cases in Texas". New York Times. Retrieved August 5, 2016.
  55. ↑ "White House scrambles to ease concerns over Ebola, lawmakers demand changes: CDC". Fox News. October 15, 2014. Retrieved October 15, 2014.
  56. ↑ Morrison, J. Stephen. "Thomas Frieden And The U.S. Ebola Response". healthaffairs.org. Project HOPE: The People-to-People Health Foundation, Inc. Retrieved January 6, 2017.
  57. ↑ Gottlieb, Scott (October 17, 2014). "In The Ebola Fight, A Defense Of Embattled CDC Chief Thomas Frieden". Forbes. Retrieved January 6, 2017.
Awards and achievements
Preceded by
Julie Gerberding		 CDC/ATSDR
Centers for Disease Control and Prevention
Director/Administrator
2009–2017 		Succeeded by
Anne Schuchat
Preceded by
Neal L. Cohen		 New York City
Department of Health and Mental Hygiene
Commissioner
2002–2009 		Succeeded by
Thomas A. Farley
Preceded by
Monique Dixon
Diana Reyes		 NY1's New Yorker of the Year Succeeded by
Common Cents
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