Thomas R. Frieden has been since 2009 the Director of the U.S. Centers for Disease Control and Prevention (CDC) and Acting Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR). He was appointed by President Barack Obama. He served as Commissioner of the New York City Department of Health and Mental Hygiene from 2002–09.
Frieden graduated from Oberlin College (BA, 1982), Columbia University College of Physicians and Surgeons (MD, 1986) and Columbia University Mailman School of Public Health (MPH, 1985). He completed training in internal medicine at Columbia-Presbyterian Medical Center and sub-specialty training in infectious diseases at Yale University.
Frieden's work on tuberculosis in New York fostered public awareness and helped improve public funding (city, state and federal) for TB control. The epidemic was controlled rapidly, reducing overall incidence by nearly half and cutting multidrug-resistant tuberculosis by 80%. The city's program became a model for tuberculosis control.
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 (RNTCP). The 2008 RNTCP status report estimates the nationwide program resulted in 8 million treatments and 1.4 million saved lives. While in India, Frieden worked to establish a network of Indian physicians to help India's state and local governments implement the program and helped the Tuberculosis Research Center in Chennai, India, establish a program to monitor the impact of tuberculosis control services.
Frieden has been a prominent figure in the US and global response to the West African outbreak of Ebola. In a Congressional hearing on 10/16/2014, 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. The previous day, the response of the CDC to the crisis led Rep. Tom Marino (R-PA) to call for Frieden's resignation.
Upon his appointment as Health Commissioner in January 2002, Frieden made tobacco control a priority, resulting in a rapid decline after a decade of no change in smoking rates. Frieden established a system to monitor the city's smoking rate, and worked with New York City Mayor Michael R. Bloomberg to increase tobacco taxes, ban smoking from workplaces including restaurants and bars, and run aggressive anti-tobacco ads and help smokers quit. The program reduced smoking prevalence among New York City adults from 21.6% in 2002 to 16.9% in 2007 – a change that represents 300,000 fewer smokers and could prevent 100,000 premature deaths in future years. Smoking prevalence among New York City teens declined even more sharply, from 17.6% in 2001 to 8.5% in 2007, and is now less than half the national rate. The workplace smoking ban prompted spirited debate before it was passed by the New York City Council and signed into law by Mayor Bloomberg. Over time, the measure has gained broad acceptance by the public and business community in New York City. New York City's 2003 workplace smoking ban followed that of California in 1994. Frieden supports increased cigarette taxes as a means of forcing smokers to quit, saying "tobacco taxes are the most effective way to reduce tobacco use." He supported the 62-cent Federal tax on each cigarette pack sold in the United States, introduced in April 2009. One side-effect of the increased taxes on tobacco in New York is a large increase in cigarette smuggling into the state from nearby states, such as Virginia, which has a much lower tobacco tax. The Tax Foundation estimates that "60.9% of cigarettes sold in New York State are smuggled in from other states". In addition, some New Yorkers have begun to make their own cigarettes, and tobacco trucks have been 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”.
Take Care New York
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. By 2006, New York City had made measurable progress in eight of the ten priority areas.
As Health Commissioner, Frieden sought to fight HIV/AIDS with public health principles used successfully to control other communicable diseases. The most controversial aspect of this strategy was a proposal to eliminate separate written consent for HIV testing. He believes the measure would encourage physicians to offer HIV tests during routine medical care, as the CDC recommends. Some community and civil liberties advocates fought this legislation arguing it would undermine patients' rights and lead eventually to forced HIV testing. In 2010, New York State passed a new law that eased the requirement for separate written consent in some circumstances. On 14 February 2007, the NYCDHMH introduced the NYC Condom, prompting Catholic League president Bill Donohue to respond, "What's next? The city's own brand of clean syringes?" More than 36 million condoms were given away by the program in 2007.
Frieden worked to raise awareness about diabetes in New York City, particularly among pregnant women, 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.
The New York City Board of Health's decision to require laboratories to report A1C test results has 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. NPOV
To combat cardiovascular disease, New York City has adopted regulations since 2006 to eliminate trans fat from all restaurants. The restaurant industry and its political allies condemned the trans-fat measure as an assault on liberty by an overzealous "nanny state" and the measure has inspired similar laws in several US cities and the state of California. The Health Department also required chain restaurants to post calorie information to raise consumer awareness of fast food's caloric impact. The measure requires chains with 15 or more outlets to post calorie counts on menus and menu boards. It has prompted two lawsuits by the New York State Restaurant Association. In the first, New York State Restaurant Association v. New York City Board of Health, a U.S. District Court judge ruled that federal law pre-empted New York City's action and overturned it. The NYC Board of Health then repealed and re-enacted the measure. Most chains now post calorie information in their New York City outlets. Section 4205 of the Patient Protection and Affordable Care Act, signed into law in 2010, requires menu labeling nationally, for restaurant chains, disclosing on the menu boards, calories, total calories, calories from fat, amounts of fat and saturated fat, cholesterol, sodium, total and complex carbohydrates, sugars, dietary fiber, and protein.
During Frieden's tenure as Commissioner, the Health Department expanded the collection and use of epidemiological data, launching an annual Community Health Survey and the nation's first community-based Health and Nutrition Examination Survey.
Electronic health records
To improve quality and efficiency of medical care, the agency launched a large community-based electronic health records project to improve preventive care for more than one million at-risk New Yorkers.
Despite his outspokenness, Frieden has had little to say about high rates of gun deaths in the United States. Asked CNN, "Why is the nation's leading public health official, a nonstop messaging machine, not talking about something that kills more than 30,000 people a year in the United States? That's more than the number of Americans who die of AIDS or colon cancer or prostate cancer. That's more than the number of people who died in the entire international Ebola outbreak last year."
Director of CDC and Administrator of ATSDR
On May 15, 2009 the White House and the Department of Health and Human Services named Dr. Frieden the 16th director of Centers for Disease Control and Prevention (CDC) and administrator of the Agency for Toxic Substances and Disease Registry (ATSDR); he assumed his position on June 8, 2009 from the acting head, Dr. Richard E. Besser.
On announcing Frieden’s appointment, President Obama said, “America relies on a strong public health system and the work at the Centers for Disease Control and Prevention is critical to our mission to preserve and protect the health and safety of our citizens”. Frieden had previously worked for the CDC from 1990 to 2002 as an Epidemic Intelligence Service Officer in New York City and then as part of CDC’s tuberculosis control program.
Frieden also served as health advisor to New York City Mayor Bloomberg, supporting the Bloomberg Initiative to reduce tobacco use.
- Frieden TR, Sterling T, Pablos-Mendez A, Kilburn JO, Cauthen GM, Dooley SW (February 1993). "The emergence of drug-resistant tuberculosis in New York City". New England Journal of Medicine 328 (8): 521–26. doi:. PMID .
- Frieden TR, Fujiwara PI, Washko RM, Hamburg MA (July 1995). "Tuberculosis in New York City – Turning the Tide". New England Journal of Medicine 333 (4): 229–33. doi:. PMID .