Column Richard Hatzfeld

Was 2019 a High-Water Mark for Global Public Health?

There is a reason most children today live into adulthood, women around the world no longer feel like surviving childbirth is a roll of the dice and smoking cigarettes or driving without a seatbelt are viewed largely as reckless choices.

These are examples of the impact of global public health, a quiet force that has tracked alongside the most consequential moments in human advancement over the past few hundred years. Like a great supporting actor, comfortable out of the spotlight but crucial to the scene, public health has served as an essential catalyst for human potential.

To fully appreciate our progress, take a moment to consider where we were just two years ago. Routine immunization rates continued to increase, driving down vaccine-preventable deaths to their lowest levels. More women had access to contraception in 2019 than ever before. In only 10 years, half a billion fewer people required treatment against parasitic diseases. And the global incidence rate of HIV was on a steady decline.

The impact of this success is profound. Parents are more productive when they no longer need to spend hours of their day finding clean water, building cooking fires or caring for a child who is sick from an easily preventable disease. When public health works, kids stay in school, health systems function and economies thrive. It’s a phenomenon that rich and poor countries share:

Public health is one of the few things in life that confers benefits to all of us, as individuals and interconnected communities.

Which is why the trajectory for public health during the pandemic has become so worrisome. Covid-19 put a spotlight on the role of proven health interventions in everyday life. But instead of a renaissance, where most people would celebrate the role of public health and, in particular, the importance of vaccination, a variety of factors have conspired to make critical health actions the focus of widespread populist rage during the pandemic.  Rather than viewing the coronavirus as the enemy, large segments of the population seem more frightened of longstanding, scientifically-based practices.

This turn of events is already having dire consequences. In the United States and many other countries around the world, assertions of individual freedom have supplanted the collective social contract that makes public health work. Specific, common-sense measures to prevent the spread of deadly disease serve as a proxy for political allegiance. And the proliferation of counter “information” has fueled a blurring of the lines between opinion and evidence-based fact.

We’re now facing a dangerous moment for our own advancement: the most innovative scientific tools and policies we have to fight disease are merely half-measures when a growing, significant share of the population no longer believes in established public health practices or trusts the institutions charged with protecting populations.

It is wishful thinking to view the threat as anything but malignant. The spread of health misinformation has come to resemble an epidemic in its own right, undermining American health programs and spawning similar campaigns around the world.

That level of sustained misinformation has fueled attacks on public health and government officials tasked with upholding sometimes unpopular mandates, while adding another pressure point to nurses, frontline health workers and everyday civil servants who must bear the burden of an increasingly hostile response to measures intended to protect society.

As a result, the past two years have hollowed out our core public health infrastructure, both in the U.S. and abroad. Our most talented, dedicated public health specialists are being driven away because of the timidity of politicians to stand up against the mob rule of a minority of outspoken, angry citizens urged on by craven lawmakers seeking to score cheap points for political gain.

Which leads to something scarier: a populist movement fueled by right-leaning policymakers around the world to reduce funding for public health programs that have a long track record of success and bipartisan support. This is the backlash we face as a result of public health becoming the bogeyman in the pandemic instead of the virus itself.

If you think this is far-fetched fearmongering, it’s important to pay attention to the impact of populist politics on public health. Instead of validating the crucial role of public health, our mismanaged global health response has done lasting damage. What’s at stake? Much of the progress that we achieved in nearly every global health metric that mattered in 2019 could stall or be set back by decades.

We can’t afford this kind of outcome. Two or three decades ago, amid sustained attacks on environmental and social programs, companies and advocacy groups began to support programs that showed there was shared value in corporations, governments and communities working together to tackle societal issues. Today, Environmental, Social and Governance (ESG) metrics factor into how companies are valued and are part of a broader ecosystem for measuring social responsibility.

To repair the damage that has been done to our global health system, it’s time for public health to be recognized as an area of responsibility that private enterprise, governments and communities must invest in routinely.

How would this take root? Through the same channels that fostered the rise of ESG: government agencies and industry setting standards for performance on key public health contributors, including employee health programs, endorsement for proven practices such as vaccination, rapid response and public participation during health crises and sponsorship for education initiatives related to science and public health.

These may be ambitious goals, but the threat that misinformation, health worker shortages and de-funding pose to global public health programs demands a creative, ambitious response that creates a big tent for supporters and marginalizes uninformed or malicious detractors.

Public health is one of humankind’s most remarkable achievements. It’s time to defend its legacy and forge a sustainable path for future progress.


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Richard Hatzfeld
Richard Hatzfeld
Richard Hatzfeld is a global communications leader and public health champion who has led campaigns in Africa, Asia, Europe and the Americas to confront many of the most urgent health issues of our time. Richard is a senior partner at Finn Partners, leading the firm's global public health group from Washington, DC. He was previously a senior leader at Ogilvy, where he advised multinational companies, foundations and NGOs on global health issues, including infectious and parasitic diseases, maternal and child health, immunization, pandemic preparedness, and antimicrobial resistance. Before Ogilvy, Richard was communications director at the Sabin Vaccine Institute and led communications activities for their vaccine development, infectious disease and advocacy efforts, as well as the Global Network for Neglected Tropical Diseases and its award-winning END7 Campaign. Richard began his global public health career pioneering the development of the first reproductive health product line and a nationwide network of maternal/child clinics in the Democratic Republic of the Congo on behalf of USAID.

Richard Hatzfeld

Richard Hatzfeld is senior partner, Global Public Health at FINN Partners. During his 25-year career, Hatzfeld has lived and worked in Africa, Asia, Europe and North America on behalf of governments, multinational companies, foundations and NGOs. He joins FINN after five years as a global team lead at Ogilvy, where he supervised multi-national vaccine communication efforts. Prior to Ogilvy, he was the communications director at the Sabin Vaccine Institute, overseeing communications for its vaccine development and advocacy efforts, as well as for the Global Network for Neglected Tropical Diseases and Sabin's award-winning END7 Campaign.

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