Top Priorities: Prevention, Education

Dr. David Satcher, new director for the Centers for Disease Control and Prevention, has four priorities:

* First, he wants to strengthen the agency’s core public health functions--the kinds of activities that are largely invisible until they fail--that is, when there is an outbreak of food poisoning, or contaminated water makes people sick or some new mysterious illness gets a grip on the population.

“I don’t think the nation has really supported these functions because nobody gets excited about the fact that you prevented somebody from dying,” he says.

* He wants to increase the focus on urgent threats to health, including emerging or re-emerging infections such as tuberculosis, by beefing up global surveillance and tracking.

“We are a global agency,” he says. “Viruses and bacteria don’t respect borders. They don’t need passports or visas.”

* He seeks more attention on prevention--in programs to prevent the spread of AIDS, for example, and in widespread immunization programs to protect children from preventable diseases, and in programs to encourage Americans to exercise more. He expects the agency to work closely with states, local governments and the private sector to establish prevention programs and incentives to practice preventive measures.

“One-half to two-thirds of deaths in this country every year are preventable,” he says.

* He hopes to steer the agency to a new emphasis on women’s health, which he describes as “an area of neglect,” through prevention and education. He includes workplace and domestic violence against women as part of this package, as well as more education and prevention programs for sexually transmitted diseases, and breast and cervical cancers.

Although much of this agenda comes as a result of his personal and professional experiences, there is more.

“I’ve called these evolving priorities,” he says. “They come from a combination of my personal background and CDC’s background, coming to understand CDC’s history and its strengths and weaknesses.

“I’ve done a lot of listening since I’ve been at CDC. I’ve had a lot of briefings. And I’ve read the history of CDC more than once. These priorities are not just what I am, but what CDC is.”