An expert group will call for a major overhaul of the US public health system

A bipartisan group of health experts will call on Tuesday for a major review of the U.S. public health system, which will significantly expand the federal government’s role, giving Washington the power to set minimum health standards and coordinate a pool of nearly 3,000 state, local and tribal agencies. .

The recommendations stem from what the panel, the British Community’s National Public Health Fund Commission, described as inadequate and unfair in the United States’ response to the coronavirus pandemic that killed more than a million Americans.

But in a report to be released Tuesday, the commission said it also wants to address the failure of national public health agencies to protect Americans from other health risks, including drug overdose, diabetes and maternal mortality.

By recommending the creation of a new “national public health system”, the bipartisan group, funded by the Commonwealth Fund, a non-profit research group focused on health issues, has dipped its finger into controversial political waters.

While other countries have centralized public health authorities, public health in the United States is largely governed at the state and local levels. The Centers for Disease Control and Prevention, the Federal Public Health Agency, has no power to force states to act – it cannot, for example, investigate outbreaks of infectious diseases in a particular state unless invited by government officials to do so.

Public health agencies and the CDC have a long history of working together, but during the pandemic, elected government officials – especially those in the red states – were reluctant to relinquish control. When the CDC asked states to sign vaccination data sharing agreements with the federal government, for example, a number of states objected.

In its report, the panel cites “archaic approaches to data aggregation” as one of the causes of death for so many Americans. He called on Congress to empower the Ministry of Health and Human Services to establish and enforce data collection standards.

Dr Julie L. Gerberding, a member of the group who was director of the CDC under President George W. Bush, said the pandemic had “taught us that we need to have a coordinated, integrated public health network that works.” and the only way we can put this together is to have a national approach. “

The panel’s report comes as Congress considers legislation that uses a different approach to strengthening the nation’s public health infrastructure. The Senate Health Committee has adopted a bipartisan measure requiring the CDC director to be confirmed by the Senate and calling for further steps to improve coordination between national public health agencies.

The commission’s recommendations are more in-depth. The panel, chaired by Dr. Margaret A. Hamburg, Commissioner of the Food and Drug Administration under President Barack Obama, called for a new position – Deputy Secretary of Public Health – within the Ministry of Health and Human Services. the national public health system.

The Undersecretary of State will coordinate the work of more than a dozen federal agencies that play a role in public health, and will have the power to set minimum health standards for states.

“Our public health system is a federal system with states and localities that have significant autonomy – and in an appropriate way, as they adapt to the needs of their countries and communities,” Dr. Hamburg said in an interview. “However, the protection of public health that people receive does not have to depend entirely on where you live. There must be a basic set of expectations. “

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