Fort McNair, Washington DC –
In mid-February 2015, Dr. Jonathan Woodson, Assistant Secretary of Defense for Health Affairs, and National Defense University (NDU) hosted the Interagency Health Leaders Roundtable (IHLR) to improve communication, coordination and collaboration on health issues affecting national security interests. IHLR is directed and coordinated by NDU’s Joint Medical Chair for Global Health, Colonel Roberto Nang, in collaboration with the Department of Defense and other federal health agencies.
The roundtable included a plenary session featuring Dr. Karen DeSalvo, Acting Assistant Secretary for Health in the Department of Health and Human Services (HHS) and Dr. Vivek Murthy, U.S. Surgeon General. Confirmed in December 2014 at age 37, Dr. Murthy is the youngest-ever U.S. Surgeon General to be appointed, and the first of Indian descent.
Both Dr. DeSalvo and Dr. Murthy called this a “pivotal time” for public health in America and emphasized “interoperability” among government agencies, economic sectors and social institutions. Improved interoperability supports a range of missions – from the complex strategy required to fight Ebola, to having to piece together one’s own past immunization records, the speakers said.
Confirmed this past October, Dr. DeSalvo said she joined HHS to fight Ebola, which she called an “all hands on deck effort.” She described the 2014 Ebola epidemic as a public health success not only in medical terms, but in terms of hygiene, behavior, communication and organizational change across multiple levels and sectors. Beyond Ebola, DeSalvo discussed domestic health policy in the U.S., emphasizing technological investments in small communities, healthcare delivery system reform, and more accessible data for consumers. She described HHS’ shift to a value-based payment system via new incentives to the private sector. Though negligible just a few years ago, value-based payments now reach 20 percent of the U.S. market; HHS has announced it intends to reach 50 percent by 2018, DeSalvo said.
Dr. Murthy predicted a “seminal moment” on the horizon when civil sectors such as housing, urban development and transportation might adopt and incorporate public health best practices. “Medicine was intended to be far more community oriented than it is now,” he said.
Dr. SeSalvo concurred. “Public health across all sectors has the opportunity to raise the floor for everyone in this country,” she said. “Medicine [alone] has had its time, but we hit a wall in terms of life expectancy, quality of life and health indicators.”